Weber P, Heckel S, Hummel M, Dellenbach P
C.M.C.O. Schiltigheim, Strasbourg.
J Gynecol Obstet Biol Reprod (Paris). 1993;22(6):653-8.
Ogilvie's syndrome or pseudo-obstruction of the colon shows up as a clinical picture of acute obstruction of the large bowel without an associated pathological lesion as usually occurs in older patients. Three cases of Ogilvie's syndrome following Caesarean section are reported in this work. Caesarean section seems to be the most common operative procedure associated with this syndrome. Up till now 41 cases have been described in the literature. This syndrome is serious because it is possible for the caecum to burst causing faecal peritonitis which carries a heavy mortality. Seventeen cases of perforation of the caecum have been reported in the literature. The diagnosis is made by x-raying the patient's abdomen without any pre-x-ray preparation; if an enema of gastroffin is given it can be shown that there is no organic cause for the obstruction. The pathological cause seems to be disturbance of the autonomic innervation of the colon. The colon should be decompressed rapidly; and the present technique is to do this using a colonoscope with or without epidural anaesthesia. Surgery should be reserved for cases that have complications or that have been refractory to conservative treatment. Of our three cases two were treated successfully by colonoscopic decompression and one with the use of drugs.
奥吉尔维综合征或结肠假性梗阻表现为大肠急性梗阻的临床症状，但无通常在老年患者中出现的相关病理病变。本文报道了3例剖宫产术后发生奥吉尔维综合征的病例。剖宫产似乎是与该综合征相关的最常见手术。迄今为止，文献中已描述了41例。该综合征很严重，因为盲肠有可能破裂导致粪便性腹膜炎，死亡率很高。文献中已报道了17例盲肠穿孔病例。诊断通过在未进行任何X线检查前准备的情况下对患者腹部进行X线检查来进行；如果给予硫酸钡灌肠，可以发现梗阻没有器质性原因。病理原因似乎是结肠自主神经支配紊乱。应迅速对结肠进行减压；目前的技术是使用结肠镜进行减压，可在有或没有硬膜外麻醉的情况下进行。对于有并发症或对保守治疗无效的病例应进行手术。我们的3例病例中，2例通过结肠镜减压成功治疗，1例使用药物治疗。
