Idiopathic Dilatation of the Colon in a Nursing Home Resident, with a Suspected Acute Colonic Pseudo-Obstruction (Ogilvie Syndrome)

: Ogilvie syndrome (acute colonic pseudo-obstruction) represents a clinical condition with symptoms of colonic obstruction without a distinct mechanical factor. The damage to the neural ganglia in the intestinal wall is the most likely etiology. A 62-year man was admitted to the Emergency Department due to acute dyspnea and vomiting. The patient had not defecated for 10 days prior to admission. An angio-CT revealed dilated colon, especially its left part, up to 85 mm with gas inside its lumen. During laparotomy, extremely dilated colon was confirmed with signs of the intestinal wall necrosis. A left sided hemicolectomy was performed. Despite the intensive treatment in the intensive care unit (ICU), the patient died on 3rd day after the surgery. In this case, the acute pseudo-obstruction of the large intestine was recognised late. This is due to overcrowding in this type of institution, overworked staff, and their inability to give individual attention to each patient.