Acute pseudo-obstruction of the colon.

Five patients were treated for pseudo-obstruction of the colon. The symptoms, diagnostic procedures and treatment of Ogilvie's syndrome are discussed. A definitive diagnosis can be established only at laparotomy when no mechanical obstruction is found to be present. Progression of ileus and signs of peritonitis constitute an indication for laparotomy. Delay in operative therapy implies the risk of (coecal) perforation with increased mortality. Coecostomy is an adequate therapy that spares the patient a second procedure for closure of a colostomy.