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A Journal on Surgery

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Chirurgia 2008 April;21(2):109-11

language: English

Acute pseudo-obstruction of the colon (Ogilvie’s Syndrome) following pericardial effusion. Case report

Santos Rodrigues A. L. 1, Crociati Meguins L. 2, Felgueiras Rolo D. 2, Ferreira Lobato M. 3

1 Hospital de Clínicas Gaspar Vianna Department of General Surgery, Belém, Pará, Brazil
2 Health Sciences Institute Faculty of Medicine Federal University of Pará, Belém, Pará, Brazil
3 Health and Biological Sciences Center, School of Medicine State University of Pará. Belém, Pará, Brazil


Acute pseudo-obstruction of the colon is defined as a clinical syndrome characterized by impairment of large-bowel propulsion in the absence of a mechanical cause. Objective of the paper is to describe the case of an elderly man with signs of congestive heart failure due to pericardial effusion that developed acute pseudo-obstruction of the colon (Ogilvie’s syndrome). A 67 years-old man was admitted to the ICU of a hospital presenting with cutaneous paleness, colorless mucosas and moderate dyspnea. Plain chest radiography showed evidences of enlarged cardiac area. Transthoracic echocardiography revealed an important pericardial effusion with decreased left ventricle systolic function (Ejection Fraction=25%). The patient was maintained with clinical support. On the second ICU day, the patient started feeling nausea, abdominal tenderness and massive abdominal distention. CT-scan demonstrated important large-bowel dilation. During operation, no mechanical obstruction was verified and diagnosis of Ogilvie’s syndrome was established. After surgery, the patient complicated with sepsis, pneumonia and renal failure and died on the seventh post-operative day. Even though cardiac diseases are not commonly associated with Ogilvie’s syndrome, pericardial effusion must be considered as a possible underlying condition.

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