A sixty five year old female with ACPO, perforation and septic shock is presented. A retrospective confirmation of the diagnosis was made after surgery at which a grossly dilated caecum and colon were seen and a right hemicolectomy carried out. [ncbi.nlm.nih.gov]

On the other hand, patients who suffer Ogilvie's syndrome present with abdominal distention with a normal peristalsis and 40% of the cases present with normal evacuations. [elsevier.es]

• Sepsis

  An awareness of the factors implicated in its pathogenesis such as prolonged bed rest, narcotic medications, hypokalaemia, sepsis and surgery (all commonly associated with burns patients) is essential if this condition is to be avoided. [ncbi.nlm.nih.gov]

  This rarely complication occurs after medical/surgical conditions such as electrolyte imbalance, sepsis, spinal trauma/surgery, malignancy, burns and Caesarean Section (CS) [2]. [austinpublishinggroup.com]

  A 4-year-old child with electrolyte imbalance responded to neostigmine therapy and an 18-year-old patient with sepsis and surgery responded to conservative management. [journals.lww.com]

  Who’s at risk: Acutely critically ill patients (ex, Sepsis, Trauma, Metabolic derangements, Peritonitis, Kawasaki Disease ) [ Shukla, 2007 ] Chronically ill patients (ex, Malignancies, Spinal injury, Diabetes, Sickle Cell Disease) [ Khosla, 2008 ] Post-operative [pedemmorsels.com]

• Surgical Procedure

  Acute colonic pseudo-obstruction (ACPO) can occur as a potential complication following various surgical procedures. [ncbi.nlm.nih.gov]

  Trauma, sepsis, surgical procedures, neurodegenerative diseases, malignanices have been associated with this condition. Narcotic analgesics, steroids, and calcium channel blockers have also been implicated. [shmabstracts.com]

  Biopsies (tissue samples), which allow the study of both muscles and nerves under a microscope, may be obtained if a surgical procedure is performed. [chp.edu]

  Therapeutic measures include conservative management, colonoscopic decompression, and surgical procedures. The latter have been associated with high morbidity and mortality. [link.springer.com]

• Amyloidosis

  Beta2-microglobulin (A beta2M) amyloidosis is a relatively new secondary amyloidosis associated with renal failure and haemo- and peritoneal dialysis. [ncbi.nlm.nih.gov]

  […] smooth muscle cells and interstitial cells of Cajal Results from autonomic imbalance resulting in sympathetic overactivity affecting some part of colon ( Singapore Med J 2009;50:237 ) Usually congenital in children; in adults due to systemic disease (amyloidosis [pathologyoutlines.com]

  Amyloidosis: an unusual cause of intestinal pseudo-obstruction. Clin Gastroenterol Hepatol. 2018 May. 16(5):e53-e54. [Medline]. Haj M, Haj M, Rockey DC. Ogilvie's syndrome: management and outcomes. Medicine (Baltimore). 2018 Jul. 97(27):e11187. [emedicine.medscape.com]

• Malaise

  Accompanied with this, she had a six-week history of nonspecific malaise, loss of appetite, and dizziness. [hindawi.com]

• Abdominal Pain

  A few days after admission, abdominal pain with marked abdominal distention developed. There was no fever or leukocytosis. [nejm.org]

  On the second Postoperative Day (POD), she had abdominal distension and no flatus. Although she had not any abdominal pain firstly. Therefore she was treated with Disodium phosphate. [austinpublishinggroup.com]

  Gastrointestinal symptoms such as nausea, abdominal pain, and diarrhea without fever are common in patients treated with mycophenolate mofetil. [ncbi.nlm.nih.gov]

  He had not experienced similar pain in the past. There was no history of prior abdominal surgery. On examination, the patient was afebrile and in moderate distress due to his abdominal pain. [accessemergencymedicine.mhmedical.com]

• Abdominal Distension

  The most common symptoms are abdominal distension with mild to moderate abdominal discomfort; however, massive abdominal distension with mild to moderate tenderness is evident upon clinical examination. [ijcasereportsandimages.com]

  Firstly, we examined her and she has hard abdominal distension with severely abdominal tenderness like the clinical evidence of peritonitis. A plain abdominal film and abdominal ultrasound was done. [austinpublishinggroup.com]

  (His condition deteriorated with increasing abdominal distension.) [journals.lww.com]

  Abdominal x-ray in the lateral decubitus position revealed marked distension of the entire colon (Fig. 1). Fig. 1 - Abdominal x-ray in lateral decubitus position. Marked distension of entire colon. [medbc.com]

  Abdominal distension and pain were the commonest symptoms, followed by vomiting. Fever was common in patients with perforation. [ncbi.nlm.nih.gov]

• Abdominal Bloating

  During a physical exam, the health care provider will most often see abdominal bloating. [medlineplus.gov]

  Symptoms Symptoms include: Abdominal pain Bloating Constipation Nausea and vomiting Swollen abdomen ( abdominal distention ) Weight loss Exams and Tests During a physical exam, the health care provider will most often see abdominal bloating. [mountsinai.org]

  Common symptoms of Ogilvie syndrome include abdominal swelling (distention) and bloating, abdominal pain, nausea and vomiting. Some individuals have a history of chronic, sometimes severe constipation. [rarediseases.org]

  Criteria for CCPO include symptoms of recurrent bowel obstruction in the last 6 months, abdominal bloating and/or pain in the previous 3 months, evidence of bowel obstruction on radiographic imaging, and no evidence of anatomic/structural abnormality. [emedicine.medscape.com]

• Absent Bowel Sounds

  On third day of admission, he developed progressive abdominal distension with absent bowel sounds. Plain radiographs showed features consistent with ACPO. [ijccm.org]

  Abdomen was distended, moves with respiration, tympanitic to percussion, non-tender, absent bowel sounds. Per rectal examination showed full rectum. [ghrnet.org]

  Physical examination in the uncomplicated situation typically reveals a tympanic, non‐tender abdomen, with high‐pitched ‘tinkling’, reduced or absent bowel sounds. [bjssjournals.onlinelibrary.wiley.com]

• Abdominal Girth Increased

  Abdominal girth increased from 49 to 54.9 cm. Rectal examination showed ballooning of the rectum without fecal impaction. [journals.lww.com]

• Hypotension

  Selective adrenergic failure was suggested by the presence of severe orthostatic hypotension, low basal plasma catecholamine level, and absence of the expected increase on standing and by the findings of provocation tests, cardiovascular tests, and acetylcholine [ncbi.nlm.nih.gov]

  Patients with bradycardia, hypotension, signs of luminal perforation, bronchospasm, prior colonic surgery, renal failure, gastrointestinal bleeding, or use of other prokinetic drugs were denied study participation. [gastrojournal.org]

  […] respiratory compromise Drug therapy although several drugs have been tried (eg metoclopramide, erythromycin) the only neostigmine produces consistently positive results 2 mg intravenously parasympathetic stimulation can also induce: bradycardia, asystole hypotension [aic.cuhk.edu.hk]

  On examination, the patient was tachycardic (HR 115), hypotensive (BP 80/44), and tachypnoeic (RR 24). She had a nontender, grossly distended abdomen with an indentable mass in the lower left quadrant. [hindawi.com]

• Orthostatic Hypotension

  Selective adrenergic failure was suggested by the presence of severe orthostatic hypotension, low basal plasma catecholamine level, and absence of the expected increase on standing and by the findings of provocation tests, cardiovascular tests, and acetylcholine [ncbi.nlm.nih.gov]

• Sweating

  […] adrenergic failure was suggested by the presence of severe orthostatic hypotension, low basal plasma catecholamine level, and absence of the expected increase on standing and by the findings of provocation tests, cardiovascular tests, and acetylcholine sweat [ncbi.nlm.nih.gov]

  […] neostigmine produces consistently positive results 2 mg intravenously parasympathetic stimulation can also induce: bradycardia, asystole hypotension restlessness fits tremor miosis bronchoconstriction hyperperistalsis nausea, vomiting salivation diarrhoea sweating [aic.cuhk.edu.hk]

• Skin Rash

  Other complications may occur outside the gastrointestinal tract and include anemia, skin rashes, arthritis, inflammation of the eye, and tiredness. The skin rashes may be due to infections as well as pyoderma gangrenosum or erythema nodosum. [play.google.com]

• Suggestibility

  Selective adrenergic failure was suggested by the presence of severe orthostatic hypotension, low basal plasma catecholamine level, and absence of the expected increase on standing and by the findings of provocation tests, cardiovascular tests, and acetylcholine [ncbi.nlm.nih.gov]

• Irritability

  Use * for blank tiles (max 2) Advanced Search Advanced Search Use * for blank spaces Advanced Search Advanced Word Finder See Also in English irritable bowel syndrome irritable bowel syndrome bowel incontinence pag-inom sa bituka bowel obstruction pag-obra [wordhippo.com]

  On symptoms, fecal microbiota and metabolite profiles in patients with irritable bowel syndrome Atrophic submucosal neurons in Parkinson´s disease Neurophysiology measures in IBS: Interactions and relevance for symptoms Pancreatic exocrine insufficiency [gdgr.svenskgastroenterologi.se]

  irritability R45.4 ICD-10-CM Diagnosis Code R45.4 Irritability and anger 2016 2017 2018 2019 Billable/Specific Code duodenum K59.8 ileum K59.8 jejunum K59.8 rectum K59.8 Paralysis, paralytic (complete) (incomplete) G83.9 ICD-10-CM Diagnosis Code G83.9 [icd10data.com]

  Irritable bowel syndrome. Hirschsprung's disease. Parasitic infection - eg, American trypanosomiasis. [patient.info]

  […] constipation changes in stool consistency loose, narrow stools blood in the stool, which may or may not be visible abdominal pain, cramping, bloating, or gas continual urges to defecate despite passing stools weakness and fatigue unexplained weight loss irritable [medicalnewstoday.com]

• Stroke

  He was given injection Neostigmine 2.0 mg intravenously slowly in stroke unit with monitoring of vital signs. [ijccm.org]

  This syndrome occurs in patients with serious medical and surgical illnesses including stroke, myocardial infarction, neoplasia, metabolic disturbances, spinal injury, peritonitis, sepsis, and shock, and with various medications such as narcotics, tricyclic [journals.lww.com]

  Commonly associated factors in the development of acute colonic pseudo‐obstruction Cardiovascular  Stroke  Myocardial infarction  Congestive heart failure Metabolic  Electrolyte imbalance  Liver or renal failure  Alcohol abuse Drug induced  Antidepressants [bjssjournals.onlinelibrary.wiley.com]

• Bowel Distention

  While we might not start neostigmine in the ED for this, it is good to know conservative management and bowel decompression are important to start as soon as the bowel distention is noted. [pedemmorsels.com]

• X-Ray Abnormal

  On abdominal X-rays, the small intestine is considered to be abnormally dilated when the diameter exceeds 3 cm.[8][9] On CT scans, a diameter of over 2.5 cm is considered abnormally dilated.[8][10] The surface area of the human small intestinal mucosa [en.wikipedia.org]

• Hyponatremia

  (ex, hyponatremia) Conservative therapies are preferred: [ Shukla, 2007 ] Bowel rest Nasogastric decompression Rectal tube decompression (if distention extends to sigmoid region) Discontinue offending medications Medications: Neostigmine [Hooten, 2014 [pedemmorsels.com]

  Case An 80-year-old woman with Stage 4 small cell lung cancer was admitted to an acute medical ward with severe back pain related to an osteoporotic compression fracture, constipation, and hyponatremia. [jpsmjournal.com]

Conservative treatment is the initial management, consisting of gastric decompression, bowel rest, correction of abnormal electrolytes, and treatment of the underlying cause. [ijcasereportsandimages.com]

Results of Open-Label Treatment with Neostigmine in Eight Patients. The results of open-label treatment with neostigmine are given in Table 3. [nejm.org]

If there are no criteria of gravity, initial treatment should be conservative or pharmacologic using neostigmine; decompression of colonic gas is also a favored treatment in the decision tree, especially when cecal dilatation reaches dimensions that are [ncbi.nlm.nih.gov]

As a result of this complication the prognosis worsens. Initially there are few clinical symptoms, but subsequently colonic obstruction develops which, if not treated, can cause perforation of the caecum resulting in a high mortality rate. [ncbi.nlm.nih.gov]

[…] ischemia Treatment Treat any underlying medical conditions Rectal tube decompression Colonoscopic decompression Medications such as Neostigmine Rarely, surgical decompression such as cecostomy Complications Can lead to ischemic of bowel and perforation Prognosis [learningradiology.com]

Treatment and prognosis Treatment involves correction of the underlying disorder and correction of any biochemical abnormalities. Medical treatment options include anticholinesterases like neostigmine and antibiotics like erythromycin. [radiopaedia.org]

Its occurrence following extensive paraaortic dissection in this case but no report so far of its occurrence after routine radical hysterectomy supports the most commonly proposed etiology of disturbed splanchnic nerve supply to the colon as a cause. [ncbi.nlm.nih.gov]

ETIOLOGY BEDRIDDEN11/21/2012 6 7. ETIOLOGYNEUROLOGICAL CARDIO RESPIRATORYDISORDERS INSUFFICIENCY11/21/2012 7 8. ETIOLOGY METABOLIC DISTURBANCES11/21/2012 8 9. ETIOLOGY SEVERE CONSTIPATION11/21/2012 9 10. ETIOLOGY MALIGNANCY11/21/2012 10 11. [slideshare.net]

[…] article=2286& amp;amp;Codelang=en Indexing Status Subject indexing assigned by NLM MeSH Acute Disease; Cecostomy /statistics & Colonic Pseudo-Obstruction /complications /epidemiology /therapy; Colonoscopy /statistics & Endoscopy /statistics & Humans; [crd.york.ac.uk]

AIM: To critically review the literature addressing the definition, epidemiology, aetiology and pathophysiology of acute colonic pseudo-obstruction (ACPO). [ncbi.nlm.nih.gov]

Management of Chronic Peripheral Arterial Occlusive Disease 1811 Visceral Artery Occlusive Disease Mesenteric Occlusive Disease 1827 Acute Arterial Occlusions 1837 Venous and Lymphatic Disease 1847 Vascular Access for Hemodialysis 1861 The Diabetic Foot Epidemiology [books.google.com]

Epidemiology It is a rare condition and the incidence rate is not actually known. Males are more commonly affected than females. Oglivie's syndrome is more common in the elderly. [patient.info]

An epidemiologic survey of chronic intestinal pseudo-obstruction and evaluation of the newly proposed diagnostic criteria. Digestion. 2012. 86(1):12-9. [Medline]. Saunders MD. Acute colonic pseudo-obstruction. [emedicine.medscape.com]

AIM: To critically review the literature addressing the definition, epidemiology, aetiology and pathophysiology of acute colonic pseudo-obstruction (ACPO). [ncbi.nlm.nih.gov]

Although acute colonic pseudo-obstruction is uncommon, it is important that obstetric practitioners recognize this clinical entity as the potentially fatal consequences of cecal perforation can be prevented by tube cecostomy. [ncbi.nlm.nih.gov]

Prevention of bacterial endocarditis. ‏ [books.google.com]