Case Report

Diagnostic Approach and Therapeutic Interventions in Ogilvie Syndrome in Burn Patients: A Report of Two Clinical Cases

Abstract

Ogilvie Syndrome, also known as acute colonic pseudo-obstruction (ACPO), is a rare condition characterized by the acute dilation of the colon without any obvious mechanical obstruction. It is most commonly seen in critically ill patients with severe underlying conditions. Its occurrence in burn patients is rare, yet significant, given the clinical challenges it presents. We present two cases of Ogilvie Syndrome in burn patients. The first patient was a 63-year-old male who sustained third-degree burns over 40% of his totalbody surface area (TBSA). On day 12 post-burn, he developed significant abdominal distension, and imaging confirmed severe cecal dilation (15 cm in diameter). The diagnosis of Ogilvie Syndrome was made, and initial treatment included nasogastric tube insertion, electrolyte correction, and discontinuation of opioids and other motility-inhibiting medications. After a partial response to intravenous neostigmine, a therapeutic colonoscopy was performed, which successfully relieved the gas buildup and led to a marked improvement in the patient’s condition within two days. The second patient, a 45-year-old female, presented with second or third-degree burns covering 30%
TBSA. On day 10 post-burn, she developed mild abdominal distension and vague abdominal pain. Imaging confirmed cecal dilation of 16 cm. Treatment was initiated with nasogastric decompression, oral laxatives, intravenous neostigmine, and electrolyte correction. Within three days, her condition significantly improved, and no invasive procedures were required. Both cases highlight the effectiveness of supportive care, electrolyte management, and pharmacological treatments such as neostigmine in facilitating recovery. The main takeaway is the necessity for vigilant monitoring of burn patients, particularly those at high risk for Ogilvie Syndrome, and the importance of early, appropriate interventions to ensure better patient outcomes.

[1] Siah S, Seddik H, Ababou K, Ihrai H, Drissi Kamili N. The Ogilvie syndrome in a severely burned patient. Ann Burns Fire Disasters. 2011;24(3):157-9.
[2] Valero Gasalla JV, Vazquez-Barro A, Pousa RF, Martelo VF. Acute colonic pseudo-obstruction in a burn patient.
Burns. 1993;19(6):538-40. https://doi.org/10.1016/0305-4179(93)90018-4
[3] Kadesky K, Purdue GF, Hunt JL. Acute pseudo-obstruction in critically ill patients with burns. J Burn Care Rehabil. 1995;16(2 Pt 1):132-5. https://doi.org/10.1097/00004630-199503000-00007
[4] Ross SW, Oommen B, Wormer BA. Acute colonic pseudo-obstruction: defining the epidemiology, treatment, and adverse outcomes of Ogilvie’s syndrome. Am Surg. 2016;82(2):102-11. https://doi.org/10.1177/000313481608200211
[5] Haj M, Haj M, Rockey DC. Ogilvie’s syndrome: management and outcomes. Medicine (Baltimore). 2018;97(27):e11187. https://doi.org/10.1097/MD.0000000000011187
[6] Vanek VW, Al-Salti M. Acute pseudo-obstruction of the colon (Ogilvie’s syndrome): an analysis of 400 cases. Dis Colon Rectum. 1986;29(3):203-10. https://doi.org/10.1007/BF02555027
[7] Pereira P, Djeudji F, Leduc P, Fanget F, Barth X. Ogilvie’s syndrome-acute colonic pseudo-obstruction. J Visc Surg.
2015;152(2):99-105. https://doi.org/10.1016/j.jviscsurg.2015.02.004
[8] Aguiar D, Egli B, Balic I. Fatal Ogilvie’s syndrome after hip surgery and review of the literature. Forensic Sci Med Pathol. 2022;18(2):170-5. https://doi.org/10.1007/s12024-022-00470-9
[9] Tsoutsos D, Tsakou EG, Lykoudis E. Acute colonic pseudo-obstruction (Ogilvie’s syndrome): a rare complication of severe thermal injury. Ann Burns Fire Disasters. 1999;12(2):88-91.
[10] Saunders MD. Acute colonic pseudo-obstruction. Best Pract Res Clin Gastroenterol. 2007;21(5):671-87. https://doi.
org/10.1016/j.bpg.2007.03.001
[11] Ponec RJ, Saunders MD, Kimmey MB. Neostigmine for the treatment of acute colonic pseudo-obstruction. N Engl J Med. 1999;341(3):137-41. https://doi.org/10.1056/NEJM199907153410301
[12] Durai R. Colonic pseudo-obstruction. Singapore Med J.2009;50(3):237-44.
[13] Stack PS. Ogilvie’s syndrome: would you recognize it? Postgrad Med J. 1991;89(5):131-4. https://doi.org/10.1080/00325481.1991.11700896
[14] Georgescu S, Dubei L, Zaharia M. Ogilvie’s syndrome: acute colonic pseudo-obstruction. Rom J Gastroenterol. 2003;12(1):51-5.
[15] Daabiss M. Clinical approach to acute colonic pseudo-obstruction. Curr Gastroenterol Rep. 2009;11(5):463-8.
[16] Soltany A, Hraib M, Apelian S. Postburn abdominal pain of gastrointestinal origin: a scoping review. Plast Reconstr Surg Glob Open. 2024;12(11):e6300. https://doi.org/10.1097/GOX.0000000000006300
[17] Obeidat RA, Alshwayyat S, Alshwayyat T. Ogilvie syndrome with caecal perforation following caesarean section: a rare case report from Jordan. Ann Med Surg (Lond). 2024;86:6261-5. https://doi.org/10.1097/MS9.0000000000002524
[18] Nelson JD, Urban JA, Salsbury TL, Lowry JK, Garvin KL. Acute colonic pseudo-obstruction (Ogilvie syndrome) after arthroplasty in the lower extremity. J Bone Joint Surg Am. 2006;88(3):604-10. https://doi.org/10.2106/00004623-200603000-00020
[19] Jusabani AM, Jusabani MA, Patel DK. Ogilvie syndrome: peculiar manifestation of AIDS in a non-institutionalized middle-aged female. Pan Afr Med J. 2020;37:298. https://doi.org/10.11604/pamj.2020.37.298.2525
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IssueVol 11 No 3 (2026): May-June QRcode
SectionCase Report(s)
Keywords
Ogilvie syndrome Acute colonic pseudo-obstruction Burn patients Neostigmine
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1.
Hojjati M, Shabankhani K, Sobhani S. Diagnostic Approach and Therapeutic Interventions in Ogilvie Syndrome in Burn Patients: A Report of Two Clinical Cases. CRCP. 2026;11(3):105-110.