Advertisement

Sign up for our daily newsletter

Advertisement

Ogilvie s syndrome from hypothyroidism: Abdominal compartment syndrome secondary to myxedema ileus

Davidson,Lawrence J. Alleemudder, and D.

Matthew Cox
Sunday, October 18, 2020
Advertisement
  • Ogilvie H. J Clin Endocrinol Metab.

  • Cited by: 3 articles PMID: Polyethylene glycol matrix reduces the rates of photochemical and thermal release of nitric oxide from S-niroso-N-acetylcysteine.

  • Polyethylene glycol matrix reduces the rates of photochemical and thermal release of nitric oxide from S-niroso-N-acetylcysteine. Supportive measures and decompressive colonoscopy were not of great benefit.

  • J Endocrinol. On neurological evaluation, the patient was conscious but drowsy, and was unable to recognize the relatives.

Continuing Education Activity

A year-old lady presented with fever, altered sensorium, obstipation, bradycardia and abdominal distension. Laxatives are generally avoided because fluid tends to accumulate in the bowel. There is a hypothyroidiam of nitric oxide in hypothyroidism which is further responsible for gut motility disorder [ 8 ]. One study on the prevalence of ACPO as a postoperative complication of hip arthroplasty recorded 3 out of 30 cases to have underlying hypothyroidism prior to surgery. A year-old lady with no previous co-morbidities presented with history of fever of 6 days, non-projectile vomiting, obstipation and altered sensorium of 2 days duration.

MI presenting as ACS has been rarely reported and requires urgent decompression. Bowel sounds were not hypothyroidism treatment, tympanitic note was present all over abdomen. Massive dilatation of colon in our case led to ACS. Support Center Support Center. Acute pseudo-obstruction of the colon is known as Ogilvie syndrome OS. National Center for Biotechnology InformationU. If laparotomy is performed on the patient with ileus, the complications of myxedema coma and death may follow.

Release reflexes or cranial nerve deficit were not present, gag reflex was preserved, ogilvie s syndrome from hypothyroidism patient was moving all four limbs, cerebellum could not be assessed, there was no neck rigidity. It can also be classified into acute or chronic. Abdominal compartment syndrome ACS complicating colonic obstruction has been described. Massive dilatation of colon in our case led to ACS. There are various methods used for measuring IAP. Usually, in OS, cecal dilatation is maximum which is in accordance with Laplace's law, which states that the intraluminal pressure needed to stretch the wall of a hollow tube is inversely proportional to its diameter.

StatPearls [Internet].

Wegener M, Borsch G. Pseudo-obstruction is defined as distension of colon without any physical cause [ 3 ]. Philadelphia: Elsevier Saunders;

  • Dis Colon Rectum.

  • Other differential diagnoses include toxic mega colon and ischemic colitis.

  • An impression of encephalopathy secondary to hyponatremia was made.

  • Vanek and M. Kalu, A.

Ganglionic hypothyroirism with guanethidine followed by cholinergic stimulation with neostigmine can be effective. Where to Start MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic. Peritoneal lavage was performed afterwards, 2 abdominal drains were inserted, and the incision site was closed with staples. In: StatPearls [Internet]. Abdominal radiograph revealed gas-filled loops of large intestine [ Figure 2a ].

  • Enterotomy and colonic decompression were done.

  • The medication is usually administered as a 2-mg, slow, IV push over 2 to 5 minutes. This case report reviews the clinical characteristics, diagnostic methods, and management of Ogilvie's syndrome.

  • Pseudo-obstruction is defined as distension of colon without any physical cause [ 3 ]. On digital rectal examination, there was mucus with no other significant finding.

  • Figure 1.

  • The main theories involve an imbalance of autonomic influences, which produces a hypotonic bowel, either through increased sympathetic activity or through decreased parasympathetic activity.

Thyroid profile was done and gave the following results: T3 0. It is important to remember that not all patients that develop ACPO are hospitalized. Bastenie PA. The mechanism of Ogilvie's syndrome is poorly understood and likely to be multifactorial. Dig Dis Sci ;

CT scan can also show hypoyhyroidism of ischemia such as mucosal wall thickening, submucosal edema, or gas. Liver function tests, lipase, and human chorionic gonadotropin HCG should be obtained to help rule out other causes of acute abdominal pain. Intestinal disorders in hypothyroidism: Clinical and manometric study. Dig Dis Sci ; Kardon,Mark A. Intestinal Pseudo-obstruction.

The main theories involve an imbalance of ogilvie s syndrome from hypothyroidism influences, which produces a hypotonic bowel, syyndrome through increased sympathetic activity or through decreased parasympathetic activity. The encephalopathy was thought to be resulting from hyponatremia. Hence a final diagnosis of acute compartment syndrome secondary to acute pseudo-obstruction due to myxedema ikeus was made.

A possibility hypothyroifism hypothyroidism was considered due to the presence of bradycardia, hyponatremia and altered sensorium. Massive dilatation of colon in our case led to ACS. She was started on replacement with thyroxin from Day 5. Hence a final diagnosis of acute compartment syndrome secondary to acute pseudo-obstruction due to myxedema ikeus was made. Deposition of mucopolysaccharides in interstitium leads to dissociation of Auerbach's and myenteric plexus from muscles leading to atony and later degeneration of muscle fibers [ 6 ].

There were no distended bowel loops on abdominal radiograph on follow-up. References H. After review of cases, we suggest the management algorithm see Figure 2. Best Pract Res Clin Gastroenterol. Common adverse effects include abdominal discomfort, salivation, and vomiting which are usually benign and transient.

It is suspected that there is reduced activity of stimulatory neurotransmitters, chiefly acetylcholine, relative to that of the inhibitory neurotransmitters, nitrous oxide, and vasoactive intestinal peptide. In: StatPearls [Internet]. CT scan with oral and intravenous IV contrast is the preferred modality for diagnosis. Aliment Pharmacol Ther.

Patient was kept nil per orally NPO and started syndrome from hypothyroidism parenteral nutrition. Hematological investigations showed hemoglobin of Colonoscopic decompression for acute pseudoobstruction of the colon Ogilvie's syndrome. Please review our privacy policy. On 1-month follow-up, there were no complaints, there was no episode of constipation, ability to tolerate cold had improved, and in general, there was a feeling of well-being. Neostigmine for the treatment of acute colonic pseudo-obstruction. Report of 22 cases and review of the literature.

Ogilvie's syndrome from hypothyroidism Colonoscopic decompression and analysis of predisposing factors. Decompression alone will recur until myxedema is treated. Ogilvie's syndrome should be diagnosed only after excluding mechanical causes for colonic obstruction. Enterotomy and colonic decompression were done. Wegener M, Borsch G. Despite these measures, the altered sensorium and abdominal distension persisted.

J Gastroenterol Hepatol ; Background: Acute colonic pseudoobstruction or Ogilvie's syndrome is a rare entity that is characterized by acute dilatation of the colon without any mechanical obstruction. N Engl J Med ; Electrolyte abnormalities should be aggressively corrected as well as any other underlying disease exacerbations.

Open in a separate window. The patient understands that her name and initial will not be published and due efforts have been made to conceal her identity, but anonymity cannot be guaranteed. On digital rectal examination, treatment was mucus with no other significant finding. There is a deficiency of nitric oxide in hypothyroidism which is further responsible for gut motility disorder [ 8 ]. Renal and liver functions were normal. Abstract Ogilvie's syndrome [acute colonic pseudo-obstruction ACPO ] presents as massive colonic dilatation without a mechanical cause, usually in critically ill patients due to imbalanced sympathetic and parasympathetic activity. It presents clinically as acute dilatation of cecum and colon.

ALSO READ: Thyroid Hormone Resistance Hypothyroidism And Pregnancy

In patients syndrome from do not resolve, intravenous neostigmine can be instituted. The case is illustrative of the need to consider hypothyroidism, a common endocrine disorder, in the differential diagnosis of Ogilvie's. Figure 2. The bradycardia and junctional rhythm were unmasked only after treatment of the sepsis. Enterotomy and colonic decompression were done.

In the syndromd case, please turn on Javascript support in your web browser and reload this page. This increased wall tension leads to colonic ischemia, fluid, and bacterial translocation, and eventually colonic perforation. Support Center Support Center. Similar Articles To arrive at the top five similar articles we use a word-weighted algorithm to compare words from the Title and Abstract of each citation. J Bone Joint Surg ; Similarly, leukocytosis can be present, especially with perforation or bowel ischemia. Cited by: 3 articles PMID:

Reassessment is important to assess whether the disease progresses or regresses. Ann Ital Chir. Medicine Baltimore97 27 :e, 01 Jul Retrospective study of neostigmine for the treatment of acute colonic pseudo-obstruction.

Case Reports in Obstetrics and Gynecology

Pseudo-obstruction is defined as distension of colon without any physical cause [ 3 ]. The abdomen was distended, and the intra-abdominal pressure IAP of the patient was 40 cm of water Ogilvie's syndrome: Colonoscopic decompression and analysis of predisposing factors.

  • Large-intestine colic due to sympathetic deprivation: A new clinical syndrome.

  • Shakir, M. Myxedema ileus: A form of intestinal pseudoobstruction.

  • J Clin Endocrinol Metab. This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.

  • After the dilated bowel has been evaluated and suction from hypothyroidism removed air, a colonic decompression tube is usually placed as close to the cecum as possible via the endoscope. Epidemiology The incidence of this disease is frequently cited as approximately cases perhospital admissions every year, although some underreporting is suspected.

  • Assess to rule out the presence of mechanical obstruction and to evaluate for perforation as this will terminate conservative management.

  • Open in a separate window. Decompression alone will recur until myxedema is treated.

Source of Support: Nil. Myxedema ileus: A from hypothyroidism of intestinal pseudoobstruction. Am J Surg. Paralytic ileus in severe hypothyroidism. There was no transition point. To the best of our knowledge, acute pseudo-obstruction presenting with compartment syndrome due to MI has never been reported. There were no distended bowel loops on abdominal radiograph on follow-up.

ALSO READ: Richie Mccaw 142 Tests For Hypothyroidism

Pathophysiology While multiple risk factors for from hypothyroidism development of ACPO have been established, a specific underlying mechanism has yet to be identified. Surg Endosc ; Medicine Baltimore97 27 :e, 01 Jul The patient was transferred to OR for exploration laparotomy. Decompression is attempted through colonoscopy without gas insufflation or bowel preparation. Surgery ;

Alleemudder, and D. Prognosis The expected prognosis is confounded by the association of multiple co-morbidities in the usual patient population as well as the underlying disease contributing to the development of ACPO. Br Med J. Am J Dig Dis ; Enhancing Healthcare Team Outcomes Ogilvie syndrome can occur due to many causes and is best managed by an interprofessional team that includes a surgeon, radiologist, internist, nurse practitioner, and gastroenterologist. Electrolyte abnormalities, including magnesium and calcium, are common and have been reported present in up to two-thirds of post-operative patients.

Publication types

Ogilvie's syndrome: Colonoscopic decompression and analysis of predisposing factors. Adynamic ileus and acute colonic pseudo-obstruction. The encephalopathy was thought to be resulting from hyponatremia.

Hence a final diagnosis of acute compartment syndrome secondary to acute pseudo-obstruction due to myxedema ikeus was made. It hypothyroidim presents in association with underlying medical or surgical disorders such as recent surgery, recent general anesthesia, medications, heart failure, infection, and electrolyte abnormality. Wegener M, Borsch G. Hypothyroidism was not recognized at presentation as it was masked by the sepsis and dyselectrolytemia.

Sympathetic innervation leads to contraction and parasympathetic to dilatation. Hematological investigations showed hemoglobin of Release reflexes or cranial nerve deficit were not present, gag reflex was preserved, the patient was moving all four limbs, cerebellum could not be assessed, there was no neck rigidity. Dis Colon Rectum. A prospective study.

Click on the link to view a sample search on this topic. ACPO is diagnosed by excluding mechanical large bowel obstruction LBO characterized by more severe abdominal symptoms and signs. Rom J Gastroenterol12 101 Mar Click on the link to view information on this topic. Keller J, Layer P.

  • No previous case report has documented myxedema coma presenting as ACPO. The case is illustrative of the need to consider hypothyroidism, a common endocrine disorder, in the differential diagnosis of Ogilvie's.

  • It is most commonly encountered in older adults with multiple underlying comorbidities but may also develop in otherwise healthy patients after a traumatic injury or following a surgical operation. Supportive care with close observation remains the primary treatment for patients with uncomplicated ACPO, although early pharmacologic intervention is increasingly encouraged.

  • Any associated electrolyte abnormalities should be corrected cautiously as they may aggravate pseudo-obstruction. The abdomen is a closed cavity with a normal pressure of 5 mmHg.

  • Adynamic ileus and acute colonic pseudo-obstruction.

Dilatation of the bowel is classically confined to the cecum and ascending colon with transition near the splenic flexure. Chen, and K. Plain radiography, consisting of upright and supine abdominal films, are commonly performed but are limited in their utility. Acute colonic pseudo-obstruction: A systematic review of aetiology and mechanisms. Accepted 19 Nov The primary goal of treatment is urgent bowel decompression. Laxatives are generally avoided because fluid tends to accumulate in the bowel.

Gut decompression was attempted with colonoscope on Day 4 of hospitalization, but remained unsuccessful. Dudley[ 2 ] in recognized the obstruction to be due to functional ogilvie s syndrome from hypothyroidism than mechanical causes and named it as acute colonic pseudo-obstruction ACPO. Usually, in OS, cecal dilatation is maximum which is in accordance with Laplace's law, which states that the intraluminal pressure needed to stretch the wall of a hollow tube is inversely proportional to its diameter. Intestinal obstruction and ileus. Abdominal X-ray of the patient showing distended large bowel with elevated diaphragm.

COVID-19 is an emerging, rapidly evolving situation.

Adynamic ileus and acute colonic pseudo-obstruction. Renal and liver functions were normal. Our patient presented with altered sensorium and abdominal distension. It presents clinically as acute dilatation of cecum and colon. Ogilvie's syndrome should be diagnosed only after excluding mechanical causes for colonic obstruction.

Haack H. N Engl J Med ; Almost all investigators agree that there is impairment of the colonic motor system, with dysfunction or imbalance of the autonomic nervous system being the most likely cause. A diagnostic scoring system for myxedema coma.

Do you syndrome from hypothyroidism of a review article? Batke M, Cappell M. Intestinal obstruction and ileus. Very few cases of perforation have been reported when the cecal diameter is less than 12 cm. Myxedema ileus: A form of intestinal pseudoobstruction. A year-old lady with no previous co-morbidities presented with history of fever of 6 days, non-projectile vomiting, obstipation and altered sensorium of 2 days duration.

Acute pseudo-obstruction of the colon Ogilvie's syndrome : An analysis of cases. Neostigmine for the treatment of acute colonic pseudo-obstruction. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal.

Laxatives are generally avoided because fluid tends to accumulate in the bowel. Routine hematological investigations were done which revealed hemoglobin of 8. Enterotomy and colonic decompression were done. The abdomen is a closed cavity with a normal pressure of 5 mmHg.

We certify that we have obtained appropriate patient consent form. OS is an acute colonic pseudo-obstruction. On neurological evaluation, the patient was conscious but drowsy, and was unable to recognize the relatives. The possible precipitants leading to ACPO could have been dyselectrolytemia and sepsis. Treatment of acute colonic pseudo-obstruction with neostigmine. Please review our privacy policy.

Postoperative period was uneventful, and the patient ogilvie s syndrome from hypothyroidism discharged on the postoperative day 8 on treatment for hypothyroidism with oral thyroxine. The increased intraluminal pressure leads to ischemia with longitudinal splitting of the serosa, herniation of the mucosa, and perforation. Jain A, Vargas HD. The patient improved and was extubated on the postoperative day 3.

  • Conservative management involves bowel rest, decompression by nasogastric tube, and rectal tube at least for 2 days. National Center for Biotechnology InformationU.

  • With progression, medical, interventional, and surgical management can be considered as described in the context. Colonic motility was restored only on starting thyroxin.

  • Pseudo-obstruction is defined as distension of colon without any physical cause [ 3 ]. Keywords: Acute colonic pseudo-obstruction, hypothyroidism, myxedema, Ogilvie's syndrome.

  • Acute colonic pseudo-obstruction. Intraoperative image showing massively dilated large bowel loops.

  • By Day 11she was feeding orally and constipation was relieved.

Colonoscopy and acute colonic pseudo-obstruction. Massive dilatation of colon in our case led to ACS. Treatment of acute colonic pseudo-obstruction with neostigmine. C ASE R EPORT A year-old lady with no previous co-morbidities presented with history of fever of 6 days, non-projectile vomiting, obstipation and altered sensorium of 2 days duration. Ogilvie's syndrome [acute colonic pseudo-obstruction ACPO ] presents as massive colonic dilatation without a mechanical cause, usually in critically ill patients due to imbalanced sympathetic and parasympathetic activity.

  • We emphasize the need to consider hypothyroidism in the differential diagnosis of any patient with acute onset LBO.

  • Europe PMC requires Javascript to function effectively.

  • Thyroid function tests of the patient revealed thyroid function test TSH of

  • Chirurgia Bucur. Traditional operative management is necessary when the interventions above are unsuccessful or when there is the development of bowel ischemia or perforation.

Subsequently, when we diagnosed hypothyroidism and instituted thyroxin replacement, gut motility was restored and her sensorium improved. Surgical exploration may precipitate myxedema coma. Decreased abdominal wall compliance, increased intra-abdominal contents, and increased capillary leak increase IAP. Dehydration, electrolyte imbalance, hyponatremia, and hypokalemia may be seen [ 2 ]. Learn More.

Surgery is reserved hypothyrpidism patients with clinical deterioration or with evidence of colonic ischemia or perforation. The patient was transferred back to ICU. J R Coll Surg Edinb ; We considered diagnosis of ACPO as no mechanical cause could be identified as responsible for the obstruction and duration of disease was less than 6 days. Close Copy Link. Neostigmine for the treatment of acute colonic pseudo-obstruction.

Patient was kept nil per orally NPO and started on parenteral nutrition. It hypothyroidism treatment important to remember that the majority of these patients will have severe underlying co-morbidities or concurrent exacerbations of chronic disease which may make the history unreliable. Management for uncomplicated patients is initially conservative with limiting oral intake, active mobilization, cessation of opioids, and correction of electrolytes, and underlying comorbidities should be treated [ 14 ]. PMID:

N Engl J Med. Perforation of cecum is the most common. Try out PMC Ogilvie s syndrome from hypothyroidism and tell us what you think. Saunders MD. It may be primary congenital and secondary acquired. Intraoperative image showing massively dilated large bowel loops. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.

Other Names:. There appears to be a relationship to cesarean operations for unclear reasons. J Surg Case Rep422 Apr Ambulation, if possible, or frequent patient repositioning may help move intestinal gas. Medicine Baltimore97 27 :e, 01 Jul ACPO is considered complicated when the patient develops any evidence of bowel ischemia, peritonitis, or perforation; the risk of complication increases directly with increasing cecal diameter and duration of illness. Surgical treatment can be either caecostomy or, in case of ischemic bowel, hemicolectomy with or without primary anastomosis or total abdominal colectomy.

Describe how an optimally functioning interprofessional team would coordinate care to enhance outcomes for patients with Ogilvie syndrome. Received 29 Sep Cebola, E. Share this content:.

Surgical exploration may precipitate myxedema coma. Large-intestine colic due to sympathetic deprivation; a new clinical syndrome. Hence a final diagnosis of acute compartment syndrome secondary to acute pseudo-obstruction due to myxedema ikeus was made. Sympathetic innervation leads to contraction and parasympathetic to dilatation.

ALSO READ: Amiodarone Induced Hypothyroidism In Dogs

Patients frequently have symptoms of bloating, flatulence, and constipation. Am Ogilvie s syndrome from hypothyroidism. The encephalopathy was fgom to be resulting from hyponatremia. Release reflexes or cranial nerve deficit were not present, gag reflex was preserved, the patient was moving all four limbs, cerebellum could not be assessed, there was no neck rigidity. Dudley[ 2 ] in recognized the obstruction to be due to functional rather than mechanical causes and named it as acute colonic pseudo-obstruction ACPO.

Durai R. Myxedema as a cause of pseudo-obstruction is extremely rare. Thus, it is important d consider the possibility of myxedema ileus in cases of marked colonic distension before subjecting them to surgery. It usually presents in association with underlying medical or surgical disorders such as recent surgery, recent general anesthesia, medications, heart failure, infection, and electrolyte abnormality. Retrospective study of neostigmine for the treatment of acute colonic pseudo-obstruction. Acute colonic pseudo-obstruction Ogilvie's syndrome : Presentation of 14 of our own cases and analysis of cases reported in the literature. Release reflexes or cranial nerve deficit were not present, gag reflex was preserved, the patient was moving all four limbs, cerebellum could not be assessed, there was no neck rigidity.

Saunders MD. Hence a final diagnosis of acute compartment syndrome secondary to acute pseudo-obstruction due to myxedema ikeus was made. There was no transition point. Acute colonic pseudo-obstruction.

Ogilvie's syndrome should be diagnosed only after excluding mechanical causes for colonic obstruction. On contrast-enhanced computed tomography Syndrome from abdomen, the colon appeared distended with maximum cecal diameter of 12 cm [ Figure 2b ]. Singapore Med J. Ogilvie's syndrome [acute colonic pseudo-obstruction ACPO ] presents as massive colonic dilatation without a mechanical cause, usually in critically ill patients due to imbalanced sympathetic and parasympathetic activity.

Release reflexes or cranial nerve deficit were not present, gag reflex was preserved, the patient was moving all hypothyriidism limbs, cerebellum could not be assessed, there was no neck rigidity. Acute pseudo-obstruction of the colon Ogilvie's syndrome : An analysis of cases. If there is severe ischemia found on endoscopy or perforation occurs, some degree of open resection is indicated with likely Hartmann procedure. Treatment options for ACPO include conservative therapy with observation, direct pharmacologic interventions, and endoscopic therapies. Intestinal Pseudo-obstruction.

Hematological investigations showed hemoglobin of It was first described by Sir Heneage Ogilvie in [ 1 ]. Abdominal girth was monitored for signs of peritonism on a daily basis.

Patients should be closely monitored for more severe complications such as bradycardia and bronchorrhea. Neurogastroenterol Motil. Ogilvie s syndrome from hypothyroidism conclude hypothyroidism to be a cause of Ogilvie's syndrome. Gastrointest Endosc Clin N Am ; It is important to remember that the diagnosis of ACPO is one of exclusion and that more common causes of functional or mechanical bowel dilatation must be investigated. Latunde-Dada, D. Camilleri M.

  • Published online Apr In the form, the patient has given her consent for her images and other clinical information to be reported in the journal.

  • Vadim Meytes,Steven P. Supportive measures and decompressive colonoscopy were not of great benefit.

  • Please review our privacy policy.

  • The development of acute colonic pseudo-obstruction is unpredictable, and there are no definite causes; however, many clinical conditions that place a patient at increased risk have been identified. Help with Travel Costs.

Colonoscopy and acute colonic pseudo-obstruction. The abdominal distension regressed gradually and sensorium improved. Factors predicting successful outcome following neostigmine ogilvie s syndrome from hypothyroidism in acute colonic pseudo-obstruction. Abdominal radiograph revealed gas-filled loops of large intestine [ Figure 2a ]. A year-old lady presented with fever, altered sensorium, obstipation, bradycardia and abdominal distension. Ileus: Use of sympathetic blocking agents in its treatment.

Open in a separate window. Hypotuyroidism and Fordtran's gastrointestinal and liver disease: Pathophysiology, diagnosis, and management. It may be primary congenital and secondary acquired. Usually, in OS, cecal dilatation is maximum which is in accordance with Laplace's law, which states that the intraluminal pressure needed to stretch the wall of a hollow tube is inversely proportional to its diameter. Indian J Endocrinol Metab.

She was discharged in a good general condition 12 days postoperatively. Surgery is reserved for patients with clinical deterioration or with evidence of colonic ischemia or perforation. Ogilvie's syndrome: Colonoscopic decompression and analysis of predisposing factors. The possible precipitants leading to ACPO could have been dyselectrolytemia and sepsis.

Bowel sounds were not heard, tympanitic note was present all over abdomen. Am J Dig Dis. N Engl J Med. In patients who do not resolve, intravenous neostigmine can be instituted. In the postoperative period, the patient was started on intravenous thyroxine.

ALSO READ: Menstruation Every 2 Weeks Hypothyroidism Vs Hyperthyroidism

Usually, in OS, cecal dilatation is maximum which ogilvie s syndrome from hypothyroidism in accordance with Laplace's law, which states that the hhpothyroidism pressure needed to stretch the wall of a hollow tube is inversely proportional to its diameter. Photochem Photobiol. Learn More. Thyroid function tests of the patient revealed thyroid function test TSH of A prospective study.

Synddrome Pseudo Obstruction of the colon as a post operative complication of hip arthroplasty. National Center for Biotechnology InformationU. She was started syndrome from broad-spectrum antibiotics empirically due to the presence of fever; however, no focus of sepsis could be identified. Decompression is attempted through colonoscopy without gas insufflation or bowel preparation. Classically, ACPO on CT scan will show isolated dilatation of the cecum and ascending colon with a gradual transition zone or "cut off" at the splenic flexure. This increased wall tension leads to colonic ischemia, fluid, and bacterial translocation, and eventually colonic perforation.

Rex DK. Ogilvie's syndrome: Successful management without colonoscopy. We conclude hypothyroidism to be a cause of Ogilvie's syndrome. Br Med J. By Day 11she was feeding orally and constipation was relieved.

Sidebar1?
Sidebar2?