A 50-year-old man on ICU develops abdominal distension and absent bowel sounds on day 5 following a severe traumatic brain injury. Abdominal radiograp...

Question

A 50-year-old man on ICU develops abdominal distension and absent bowel sounds on day 5 following a severe traumatic brain injury. Abdominal radiograph shows a massively dilated colon (caecal diameter 11 cm) with no evidence of mechanical obstruction on CT. The diagnosis is acute colonic pseudo-obstruction (Ogilvie's syndrome). What is the first-line pharmacological treatment?

Accepted Answer

IV neostigmine 2 mg over 3-5 minutes with cardiac monitoring

Answer

Oral polyethylene glycol bowel preparation

Answer

IV metoclopramide 10 mg

Answer

Rectal glycerine suppositories

Answer

Oral erythromycin 250 mg QDS

uk-fficm MCQ (SBA): Acute Colonic Pseudo-obstruction