Acute intestinal pseudo-obstruction. A potentially fatal colonic dissention in the absence of mechanical obstruction. In many cases, patients with this condition have experienced major surgery or a severe debilitating disease, such as myocardial infarction or sepsis; and have received narcotics or sedatives. Now most commonly seen in patients on chemotherapeutic regimes containing neurotoxic drugs, e.g. vincristine.
Intestinal pseudo-obstruction was first described in 1938 by the German surgeon W. Weiss. Weiss reported megaduodenum in 6 persons in 3 generations of a German family. His observation pointed to an inherited subset of intestinal pseudo-obstruction.
Ogilvie in 1948 reported the syndrome in two patients with metastatic cancer and retroperitoneal spread to the celiac plexus. Report of a third case was made by J. Dunlop in 1949. The condition was seen in men aged 56, 58, and 66 years. Large bowel colic was the predominant symptom and was accompanied by constipation, abdominal distension, and progressive loss of weight, but with no evidence of organic obstruction to the intestinal flow. Rupture of the cecum and peritonitis are the most frequent complications. In 1958, Dudley et al used the term pseudo-obstruction to describe the clinical appearance of a mechanical obstruction with no evidence of organic disease during laparotomy.
- W. Weiss:
Zur Ätiologie des Megaduodenums.
Deutsche Zeitschrift für Chirurgie, Leipzig, 1938, 251: 317-330.
- W. H. Ogilvie:
Large-intestine colic due to sympathetic deprivation: a new clinical syndrome.
The British Medical Journal, 1948, 2: 671-673.
- J. Dunlop:
Ogilvie's syndrome of false colonic obstruction.
The British Medical Journal, 1949, 1: 890-891.
- H. O. Dudley. I. S.. Sinclair, I. F. McLaren, T. J. McNair, J. E. Newsam:
Journal of the Royal College of Surgeons of Edinburgh, 1958, 3: 206-217.