AI Summary & Key Takeaways
AI InsightIn particular, in patients with no etiopathogenetic factor in personal history and family history with radiographic megacolon appearance and chronic constipation, OH should be kept in mind and should be intervened before any complications develop
📌 3 Key Takeaways
Abstract
Ogilvie's Disease (OH) is a massive dilatation of the distal colon, the etiology of which is not fully understood and is caused by sympathetic-parasympathetic innervation imbalance. Abdominal pain, nausea, vomiting and constipation are the main complaints of this disease. The treatment is generally in the form of a resection of the megacolon segment in the patient admitted to a clinic with the acute abdominal pain. In cases where early intervention is not possible, it can lead to high morbidity and mortality, such as perforation and toxic megacolon. In this case, we present a 67-year-old woman patient who was operated under emergency conditions with the diagnosis of OH. In the patient admitted to the emergency department with complaints of abdominal pain, bloating and constipation, distension, widespread defense and rebound were observed and the transverse colon diameter was determined as approximately 25 cm in the abdominal tomography. Emergency operation decision was made with the acute abdomen clinic. In intraoperative evaluation, a 5 mm diameter colon perforation in the descending colon and a megacolon with a diameter of about 30 cm proximal to the rectosigmoid junction was detected. Extended left hemicolectomy + Hartman colostomy was performed. Pathological evaluation was reported as OH. In particular, in patients with no etiopathogenetic factor in personal history and family history with radiographic megacolon appearance and chronic constipation, OH should be kept in mind and should be intervened before any complications develop
Özet
Ogilvie Hastalığı (OH), etyolojisi tam olarak bilinmeyen ve sempatik-parasempatik inervasyon dengesizliği sonucu oluşan distal kolonun masif dilatasyonudur. Karın ağrısı, bulantı, kusma ve kabızlık ana şikayetlerdir. Tedavi genelde, akut batın kliniğiyle başvuran hastada megakolon olan segmentin rezeksiyonu şeklindedir. Erken müdahale yapılamadığı durumlarda perforasyon ve toksik megakolon gibi morbidite ve mortalitesi yüksek tablolara yol açabilmektedir. Olgumuzda, OH tanısı ile acil şartlarda opere edilen 67 yaşındaki bayan hastayı sunacağız. Karın ağrısı, şişkinlik ve kabızlık şikayeti ile acile başvuran hastada distansiyon, yaygın defans ve rebound gözlenip batın tomografisinde, transvers kolon çapı yaklaşık 25 cm olarak tespit edildi. Hastaya akut batın kliniği ile acil operasyon kararı verildi. İntraoperatif değerlendirmede, inen kolonda 5 mm çaplı kolon perforasyonu ve rektosigmoid bileşkenin proksimalinde yaklaşık 30 cm çapa varan megakolon tespit edildi. Genişletilmiş sol hemikolektomi + Hartman kolostomi yapıldı. Patolojik değerlendirme OH olarak raporlandı. Özellikle özgeçmiş ve soygeçmişinde etyopatogenetik faktör anamnezi olmayan ve çekilen grafilerinde megakolon görünümü olup, kronik kabızlık şikayeti çeken hastalarda OH akılda tutulmalı ve komplikasyon gelişmeden müdahale edilmelidir.