BACKGROUND Mechanical and functional
intestinal obstruction are serious postoperative complications. Acute
colonic pseudo-obstruction (
Ogilvie's syndrome) is an acute functional obstruction of the large intestine with various causes, including
electrolyte disturbances, certain drugs,
trauma,
hypothyroidism, and, less often, certain procedures, such as abdominal, pelvic, orthopedic, cardiac, and, rarely, thoracic surgeries. It presents with abdominal distension without evidence of mechanical obstruction. This report is of a 66-year-old man with postoperative
Ogilvie's syndrome 1 day after diaphragmatic plication surgery CASE REPORT We present a case of a 66-year-old man with no pre-existing
chronic diseases who underwent diaphragmatic plication surgery performed to treat symptomatic
diaphragmatic eventration, which was associated with chronic colonic dilation. One day after the procedure, the patient experienced hemodynamic instability, abdominal tenderness and distention,
leukocytosis, and elevated erythrocyte sedimentation rate (ESR) and
C-reactive protein (CRP). An abdominal CT scan revealed massive colonic dilation with interposition of the splenic flexure into the diaphragm. Consequently, the patient underwent emergency exploratory laparoscopy, which was later converted to upper
laparotomy, during which colonic
decompression was performed without identifying any evidence of incarceration. Subsequently, colonic
decompression was repeated via sigmoidoscopy, and no mechanical obstruction was found. Lastly, medical treatment was effective in improving the patient's condition CONCLUSIONS In this complicated case, identifying the definite diagnosis was challenging due to the unusual presentation. This rare case might contribute to recognizing a new risk factor for postoperative colonic obstruction, which is preoperative colonic dilation. Also, this case has highlighted the importance of promptly diagnosing postoperative
Ogilvie's syndrome to prevent large-bowel perforation.