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J Emerg Med. 2008 Aug;35(2):167-70. doi: 10.1016/j.jemermed.2007.06.043. Epub 2008 Feb 1.

Acute colonic pseudo-obstruction: rapid correction with neostigmine in the emergency department.

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Department of Emergency Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.


Ogilvie's syndrome, now known as acute colonic pseudo-obstruction, is characterized by massive dilatation of large bowel in the absence of mechanical obstruction. It is found in a variety of patients, although elderly and immobile patients make up a large portion of the afflicted population. This article discusses the case of a 64-year-old bedridden, paraplegic, male nursing home resident who presented to the Emergency Department with a chronic history of abdominal distention that acutely worsened on the day of his arrival. A diagnosis of acute colonic pseudo-obstruction was made and 2 mg of intravenous neostigmine was administered, with resolution of the patient's condition allowing for subsequent Emergency Department discharge. This report discusses the utilization of neostigmine, an acetylcholinesterase inhibitor, for patients with colonic pseudo-obstruction. We also briefly review the literature on this condition and other therapeutic options.

[Indexed for MEDLINE]

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