Description

Vanek and Al-Salti identified factors affecting the outcome of a patient with acute Ogilvie's syndrome (pseudo-obstruction of the colon). These can help to identify a patient who may require more aggressive management. The authors are from St. Elizabeth Hospital Medical Center in Youngstown, Ohio.


 

Parameters:

(1) cecal diameter in cm

(2) time to decompression

 

Criteria for decompression - at least 1 of the following:

(1) cecal diameter > 12 cm

(2) failure to improve with conservative management at 72 hours

 

Risk factors for mortality:

(1) cecal diameter > 14 cm

(2) time to decompression > 7 days

(3) bowel rupture

(4) debilitation and/or severe comorbidity

 

Interventions:

(1) Colonoscopy is effective for decompression if done carefully.

(2) A tube cecostomy is effective if colonoscopy fails or if there is a small bowel perforation.

(3) If the bowel is ischemic or has perforated, then colonic resection with or without anastomosis is required.

 


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