A 50-year-old man on ICU develops acute colonic pseudo-obstruction (Ogilvie's syndrome). Caecal diameter is 13 cm on abdominal X-ray. IV neostigmine h...

Question

A 50-year-old man on ICU develops acute colonic pseudo-obstruction (Ogilvie's syndrome). Caecal diameter is 13 cm on abdominal X-ray. IV neostigmine has been given but the patient developed bradycardia requiring atropine and the colonic distension has not improved. What is the next step?

Accepted Answer

Colonoscopic decompression - insertion of a decompression tube beyond the splenic flexure under endoscopic guidance

Answer

Repeat neostigmine immediately

Answer

Emergency colectomy

Answer

Continue observation for 7 more days

Answer

IV erythromycin

uk-fficm MCQ (SBA): Refractory Ogilvie Syndrome

A 50-year-old man on ICU develops acute colonic pseudo-obstruction (Ogilvie's syndrome). Caecal diameter is 13 cm on abdominal X-ray. IV neostigmine has been given but the patient developed bradycardia requiring atropine and the colonic distension has not improved. What is the next step?