Intestinal Pseudo‐Obstruction (Ogilvie's Syndrome)

Intestinal pseudo‐obstruction is a clinical condition in which patients present with symptoms and signs of bowel obstruction in the absence of any occlusive gut lesion. There are two main types: acute colonic pseudo‐obstruction (ACPO) and chronic intestinal pseudo‐obstruction (CIPO). The true incidence of ACPO is unknown but majority of these patients are middle aged or elderly. CIPO is largely idiopathic in origin. Most are sporadic in nature but familial forms have been reported including autosomal dominant, autosomal recessive, and X‐linked recessive. Postoperative ileus and CIPO, entities that used to be part of Ogilvie's syndrome, are recognized to have very different underlying pathophysiology and clinical course. A common first‐line investigation performed would be an abdominal radiograph demonstrating dilated large bowel loops. Conservative management is the mainstay of treatment due to its high success rate of between 77% and 96% and time to response has been reported to be between three to five days.