[Acute pseudo-obstruction of the colon (Ogilvie's syndrome). Internal medicine aspects].

Four patients with acute colonic pseudo-obstruction are described. The clinical and radiological picture is suggestive of colonic obstruction, without detectable organic obstruction. The syndrome usually occurs after surgery or trauma, or is related to severe preexisting systemic illness; its association with alcohol intake is frequently overlooked. The most severe complication is cecal rupture, which may occur at a diameter of 12 cm or more and which has a lethality rate of 40%. The primary management of colonic pseudo-obstruction is conservative, and includes an attempt at colonoscopic decompression; in most cases cecostomy can be avoided.