Ogilvie's syndrome post hysterectomy: a case report and literature review
DOI:
https://doi.org/10.18597/rcog.334Keywords:
Ogilvie's syndrome, acute colonic pseudo-obstruction, complication, hysterectomy, caesarean sectionAbstract
Objective: presenting the workup and management of a pregnant woman who presented Ogilvie's syndrome as a complication of an obstetric hysterectomy and describing the epidemiology, physiopathology and clinical findings following gynecobstetric procedure and treatment of this pathology by means of a literature review.
Case report: the case of a 28-year-old woman is presented; the patient presented uterine atony following normal vaginal delivery after 38 weeks' pregnancy. A subtotal abdominal hysterectomy was made due to lack of improvement with medical management. The patient presented fever, intolerance to oral route, tachycardia, distended and hypertympanic abdomen, pain in response to surface and deep palpation of the right hemi-abdomen and decreased peristalsis during postoperative period. The abdominal radiograph revealed obstruction of the small intestine; exploratory laparotomy was thus carried out, showing foetal peritonitis and perforation of the colon at the ileocecal valve without evidence of mechanical obstruction.
Discussion: Ogilvie's syndrome is characterised by massive and progressive dilatation of the colon in the absence of small bowel obstruction. The syndrome mainly develops in hospitalised patients suffering from severe medical conditions; nonetheless, it also occurs after gynecobstetric procedures. Because this syndrome is associated with high rates of morbidity andmortality,thegynecobstetricianmustrecognise this syndrome as being a possible complication of gynecobstetric procedure.
Author Biographies
Jairo Hernández-Pinzón
Médico General, Servicio de Control Prenatal, Hospital Comunal Malvinas. Regional Representative of Latin-America S.N.O, The Network: TUFH (Towards Unity for Health). Grupo de Investigación: Salud Sexual y Procreativa de la Mujer, Facultad de Medicina, Universidad de la Sabana, Clínica Universitaria Teletón, Chía (Colombia).
Marcos Castillo-Zamora
Especialista en Ginecología y Obstetricia. Profesor Auxiliar, Universidad de La Sabana, Chía (Colombia).
Carolina Rodríguez
Especialista en Cirugía General. Profesora Auxiliar, Universidad de La Sabana, Chía (Colombia).
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