Approach to the management of the adult patient with acute colonic pseudo-obstruction (Ogilvie syndrome)

* Patients with colonic ischemia, perforation, or peritonitis require urgent exploration, lavage, or drainage of the peritoneal cavity. The need for and extent of bowel resection, as well as the type of stoma, are dictated by patient anatomy and clinical presentation.

¶ Supportive care includes administering nothing by mouth, nasogastric decompression, intravenous fluid and electrolyte replacement, and discontinuation of medications that can adversely affect colonic motility (eg, narcotics and anticholinergic agents).

Δ Monitoring includes serial physical examination, plain abdominal radiographs to evaluate the colonic diameter, and laboratory tests for complete blood count and electrolytes every 12 to 24 hours.