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01 September 2023 : Case report  Poland

[In Press] Ogilvie’s Syndrome in a Patient at 23 Weeks of Pregnancy: Report of a Rare Case with Successful Surgical Intervention

Challenging differential diagnosis, Management of emergency care, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)

Bartosz Wilczyński ORCID logo1ABCDEFG, Jan Śnieżyński ORCID logo1ABCDFG

DOI: 10.12659/AJCR.941283

Am J Case Rep In Press; DOI: 10.12659/AJCR.941283  

Available online: 2023-09-01, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule

Abstract

BACKGROUND
Ogilvie’s syndrome (acute colonic pseudo-obstruction) is a syndrome characterized by symptoms suggestive of intestinal obstruction without an identifiable mechanical cause. It presents with excessive dilation of the loops of the large intestine. The treatment options include conservative management, endoscopic methods, and surgical intervention. If appropriate treatment is not implemented promptly, this syndrome can lead to life-threatening complications for the patient. Acute colonic pseudo-obstruction typically occurs in elderly individuals with numerous chronic diseases, extensive surgeries, or trauma. In younger individuals, risk factors include gynecological procedures, pregnancy, and childbirth.
CASE REPORT
This work presents a case of a 30-year-old woman at 23 weeks of pregnancy. She presented with persistent abdominal pain, nausea, and vomiting for several days. The patient was initially treated at the Obstetrics Clinic, where conservative management was implemented. Due to worsening symptoms after confirming pathological distension of the colon in the magnetic resonance imaging examination, she was transferred to the surgery clinic. Due to her unstable general condition and lack of improvement with conservative treatment, she was qualified for an appendectomy with the formation of a cecostomy. The performed surgical treatment led to an improvement in the patient’s condition and did not have a negative impact on the further development of the child.
CONCLUSIONS
Ogilvie’s syndrome in pregnancy is an extremely rare condition that can lead to significant complications. Its treatment requires the coordinated efforts of a multidisciplinary team of specialists. During the course of therapy, it is important to consider the limitations imposed by pregnancy on diagnostic and therapeutic methods.

Keywords: Colonic Pseudo-Obstruction; Colorectal Surgery; Critical Care; Gynecology; Pregnancy Complications

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923