Tắc nghẽn giả đại tràng cấp tính: Nhân một trường hợp và tổng quan y văn

Acute colonic pseudo-obstruction, also known as Ogilvie's syndrome, represents a rare yet potentially fatal medical condition characterized by significant colonic dilatation without mechanical obstruction. This syndrome predominantly affects patients with multiple comorbidities, a history of trauma, or those in a postoperative state. Despite its critical nature, diagnosis and subsequent management pose significant clinical challenges, as delays or inappropriate interventions can lead to severe complications such as colonic ischemia or perforation. This paper aims to present a detailed clinical case of Ogilvie's syndrome, alongside a comprehensive literature review, to underscore the paramount importance of early recognition and appropriate therapeutic intervention. The objective is to enhance understanding of this uncommon condition, thereby contributing to timely diagnosis and effective treatment strategies to prevent life-threatening outcomes.

Medical professionals, including gastroenterologists, general surgeons, emergency physicians, and internal medicine specialists, who encounter patients with acute abdominal conditions or require updated knowledge on rare gastrointestinal disorders.

This study investigates acute colonic pseudo-obstruction, or Ogilvie's syndrome, a rare condition characterized by substantial colonic dilatation in the absence of mechanical blockage. Often associated with comorbidities, trauma, or surgical recovery, it carries a high mortality risk if not promptly and accurately managed. We present the case of a 72-year-old male with a history of Parkinson's disease, type 2 diabetes mellitus, and previous nephrectomy, who developed severe abdominal distension and pain. Despite initial conservative therapy, his condition worsened, necessitating emergency admission. Imaging, including X-ray and CT scans, revealed widespread colonic dilatation, initially suggesting sigmoid volvulus. Subsequent emergency surgery confirmed diffuse colonic dilatation without evidence of mechanical obstruction, leading to a definitive diagnosis of Ogilvie's syndrome. The patient underwent a diverting colostomy to decompress the colon, followed by Neostigmine administration and electrolyte correction. The discussion highlights that early management, encompassing conservative measures and colonoscopic decompression, is crucial to prevent rapid colonic distension from progressing to perforation and generalized peritonitis, which often require timely surgical intervention. The findings emphasize that a high index of suspicion, coupled with prompt diagnostic imaging to rule out mechanical obstruction, is vital for improving patient outcomes and reducing the high morbidity and mortality associated with this critical condition.