Ogilvie's syndrome : a new approach to an old problem

This study was designed to determine the value of intravenous neostigmine in achieving adequate colonic decompression in patients with Ogilvie's syndrome. A prospective study was undertaken in 12 consecutive patients (median age, 60 (range, 38-98) years) with contrast enema-proven Ogilvie's syndrome (median duration, four (range, two-nine) days) Satisfactory clinical decompression of large bowel distention was attained in 11 patients, although one required colectomy for subsequent recurrence and ischemia. These results support the theory that many cases of Ogilvie's syndrome are the result of excessive large bowel parasympathetic suppression rather than sympathetic overactivity.