Ogilvie Syndrome (Acute Colonic Pseudo-Obstruction)

Acute colon dilation in the absence of mechanical obstruction.

Written by: Saygı Hospital Health Guide Editorial Board

Last updated: June 10, 2026

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Ogilvie Syndrome (Acute Colonic Pseudo-Obstruction)?

Ogilvie syndrome — also known as acute colonic pseudo-obstruction (ACPO) — is massive colonic dilation without an underlying mechanical obstruction. It typically occurs in critically ill, postoperative, or otherwise debilitated patients.

Pathophysiology involves autonomic imbalance with reduced parasympathetic and increased sympathetic tone; once cecal diameter exceeds 12 cm, perforation risk rises sharply.

Diagnosis is one of exclusion after ruling out mechanical obstruction. Management includes nasogastric decompression, mobilization, and electrolyte correction, with neostigmine or colonoscopic decompression when needed.

Symptoms

Marked abdominal distension and tightness

Diffuse or right lower quadrant abdominal pain

Nausea and vomiting

Inability to pass flatus or stool

Fever if perforation has occurred

Tachycardia and hemodynamic instability

Risk Factors

Recent major surgery

Intensive care unit admission

Electrolyte imbalances — hypokalemia and hypomagnesemia

Opioid use

Sepsis and severe infection

Underlying neurological disorders

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

Marked postoperative abdominal distension and inability to pass gas
Worsening abdominal distension in an ICU patient
Abdominal pain accompanied by fever and tachycardia
Imaging that shows cecal diameter greater than 12 cm

Treatment Methods

Conservative care — bowel rest and nasogastric decompression

Correction of electrolyte disturbances

Discontinuation of opioids and anticholinergic agents

Neostigmine infusion for parasympathetic stimulation

Colonoscopic decompression

Surgical intervention in case of perforation

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Dahiliye (İç Hastalıkları) Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.