Acute colonic pseudo-obstruction (Ogilvie syndrome) after arthroplasty in the lower extremity.
نویسندگان
چکیده
BACKGROUND Acute colonic pseudo-obstruction, also known as Ogilvie syndrome, is an uncommon postoperative complication of total hip and total knee arthroplasty that is characterized by massive colonic dilatation and the potential for substantial morbidity and mortality. METHODS We conducted a retrospective case-control study of 1170 total hip and knee arthroplasties performed by one surgeon from 1995 to 2002, and identified eighteen patients with Ogilvie syndrome. Radiographs and medical records were analyzed for risk factors and treatment effectiveness. RESULTS Eleven (1.6%) of 708 patients who had a total hip arthroplasty and seven (1.5%) of 462 patients who had a total knee arthroplasty had Ogilvie syndrome develop postoperatively. Seventeen of these patients had preoperative conditions and/or had received medications identified as risk factors for Ogilvie syndrome. The use of patient-controlled analgesia was associated with an earlier development of symptoms. Colonic decompression was performed in seven patients and was associated with a significantly shorter hospital stay (p = 0.019). CONCLUSIONS Acute colonic pseudo-obstruction was equally prevalent after total hip and total knee arthroplasties. Most patients who had Ogilvie syndrome had risk factors that could be identified preoperatively. Knowledge of these risk factors can enable the physician to anticipate which patients may have Ogilvie syndrome develop and, therefore, to be vigilant for its development and judicious in the use of patient-controlled analgesia. We also found that decompressive colonoscopy reduced the risk of perforation and decreased the length of hospitalization for the patients in whom Ogilvie syndrome developed.
منابع مشابه
انسداد کاذب روده یا سندرم 0gilvie
ABSTRACT Acute pseudo–obstruction of the colon or ogilvie syndrome results in massive colonic dilatation that may lead to a life threatening perforation. Pseudo–obstruction are terms used to denote a condition in which patients appear to have signs and symptoms suggestive of intestinal obstruction without an evident mechanical source. This problem is often seen in association with other disease...
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ورودعنوان ژورنال:
- The Journal of bone and joint surgery. American volume
دوره 88 3 شماره
صفحات -
تاریخ انتشار 2006