A 70 year old man with multiple medical conditions including a recent pneumonia, a recent MI, and Parkinson's disease presents with nausea, vomiting, constipation, and diarrhea. On exam, his abdomen is so distended that it causes labored breathing. The abdomen is tympanic and bowel sounds are present. Labs show hypokalemia, hypocalcemia, and hypomagnesemia. Further workup excludes toxic megacolon and mechanical obstruction. The treatment is neostigmine.Challenge: What is this eponymous disease?
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Obstruction 2
This is Ogilvie’s syndrome or acute colonic pseudoobstruction which is associated with underlying disease including trauma, infection, cardiac problems, OBGYN issues, abdominal or pelvic surgery, neurologic disease, or other medical conditions. It involves gross dilatation of the cecum and right hemicolon in the absence of an anatomic lesion that obstructs flow of intestinal contents.
Sources: UpToDate; radiology.co.uk.
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