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[奥吉尔维综合征作为腰椎管狭窄症手术的罕见并发症:两例报告及文献综述]

[Ogilvie´s syndrome as a rare complication of lumbar stenosis surgery: report of two cases and literature review].

作者信息

Gankpé Gbètoho Fortuné, Do Laurent, Rabhi Mohammed

机构信息

Service de Neurochirurgie, Centre Hospitalier Universitaire Hassan II, Fès, Maroc.

Service de Neurochirurgie, Centre Hospitalier Universitaire, Guadeloupe, France.

出版信息

Pan Afr Med J. 2022 May 4;42:2. doi: 10.11604/pamj.2022.42.2.21183. eCollection 2022.

Abstract

Ogilvie´s syndrome is an acute colonic pseudo-obstruction, characterized by massive colonic distension in the absence of mechanical cause. It is a very rare pathology after spinal surgery. We report two cases in the neurosurgery department of the University Hospital of Guadeloupe. A 79-year-old woman overweight (BMI= 27kg/m) and a 56-year-old man experienced history of non-systematized bilateral lumbar and sciatic pain with reduction in walking perimeter for few months. MRI of lumbar spine had revealed a lumbar stenosis with disc herniation. They had undergone decompression surgery with laminectomy. The surgical intervention was uneventful perioperatively. By 48 hours after surgery, they had complained of constipation with cessation of fecal and flatus with resultant abdominal distension. Abdominal CT scan and X-rays showed significant bowel distension with no mechanical obstruction, suggestive of Ogilvie´s syndrome. Conservative treatment had been sufficient to treat this syndrome and the patients completely recovered. In the occurrence of Ogilvie´s syndrome, the most frequent pathology is the lumbar disc herniation. The clinical presentation is typical with a cessation of fecal and gas elimination, and abdominal distension. Conservative treatment remains the treatment of choice when diagnosis is made early.

摘要

奥吉尔维综合征是一种急性结肠假性梗阻,其特征是在没有机械性病因的情况下出现结肠大量扩张。它是脊柱手术后一种非常罕见的病症。我们报告在瓜德罗普大学医院神经外科的两例病例。一名79岁超重女性(体重指数=27kg/m)和一名56岁男性,有几个月的非系统性双侧腰腿痛病史,行走范围减小。腰椎磁共振成像显示腰椎管狭窄伴椎间盘突出。他们接受了椎板切除术减压手术。手术干预围手术期顺利。术后48小时,他们主诉便秘,停止排气排便,导致腹胀。腹部CT扫描和X线显示肠管明显扩张,无机械性梗阻,提示奥吉尔维综合征。保守治疗足以治愈该综合征,患者完全康复。在奥吉尔维综合征的发病中,最常见的病症是腰椎间盘突出症。临床表现典型,即停止排气排便和腹胀。早期诊断时,保守治疗仍是首选治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/158a/9142784/7c0ac1bf3389/PAMJ-42-2-g001.jpg

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