Ogilvie syndrome miasms

Clinic

• Ogilvie syndrome is the acute dilatation of the colon in the absence of any mechanical obstruction
• Acute colonic pseudo-obstruction = Ogilvie syndrome is characterized by massive dilatation of the cecum
• It is a type of megacolon, sometimes referred to as "Acute megacolon," to distinguish it from toxic megacolon.

• It has considerable morbidity and mortality
• Causation: Imbalance in autonomic nervous supply to the colon.

Signs / Symptoms

• Usually the patient has abdominal distention, pain and altered bowel movements.
• There may also be nausea and vomiting.

Pathophysiology

• The exact mechanism is not known. The probable explanation is imbalance in the regulation of colonic motor activity by the autonomic nervous system.
• Acute megacolon develops because of abnormal intestinal motility. Normal colonic motility requires integration of myogenic, neural, and hormonal influences.
• Enteric nervous system is independent but is connected to CNS by sympathetic and parasympathetic nerves.
• The targets of the enteric neurons are muscle cells, secretory cells, endocrine cells, microvasculature, and inflammatory cells.
• Neurons of enteric plexuses are stimulated by a food bolus, which both distends the gut and stimulates the mucosal surface, leading to the release of factors that stimulate interneurons. The stimulated interneurons transmit excitatory signals proximally, which cause contraction and inhibitory signals distally, and these in turn cause relaxation.
• These signals are transmitted by the neurotransmitters acetylcholine and serotonin.
• Acute megacolon can also lead to ischemic necrosis in massively dilated intestinal segments.

Miasms

VZV

Ogilvie syndrome vs Ileus

• Both refer to intestinal dysmotility syndromes that have symptoms, signs, and the radiologic appearance of bowel
• Ileus usually arises from an exaggerated intestinal reaction to abdominal surgery that is often exacerbated by numerous other conditions.
• Colonic pseudo-obstruction is induced by numerous metabolic disorders, drugs that inhibit intestinal motility, severe illnesses, and extensive surgery.