Postpartum Acute Pseudo-Obstruction of the Colon (Ogilvie's Syndrome) Leading to Perforation After Spontaneous Vaginal Delivery

Cureus. 2024 Nov 2;16(11):e72881. doi: 10.7759/cureus.72881. eCollection 2024 Nov.

Abstract

Acute pseudo-obstruction of the colon (Ogilvie's syndrome) leading to perforation is a rare post-surgical complication. Most commonly associated with cesarean sections, only one case has been previously reported in the literature that occurred after normal vaginal delivery. We present the case of a 31-year-old female who presented on the seventh day following spontaneous vaginal delivery with abdominal distension, intermittent episodes of watery diarrhea, and sudden severe generalized abdominal pain. Radiological imaging showed evidence of pneumoperitoneum and perforation of the bowel. A right-sided hemicolectomy was performed after an exploratory laparotomy revealed perforation of the cecum. Initially considered a diagnosis of exclusion, Ogilvie's syndrome is a rare and multifactorial post-surgical complication. This case report emphasizes the significance of early detection and initiation of treatment, which can minimize the possibility of developing mortality-associated sequelae of this disease.

Keywords: colonic pseudo-obstruction; endoscopic decompression; neostigmine; ogilvie's syndrome; open cecostomy; perforated colon.

Publication types

  • Case Reports