症例 challenge · Gastroenterology / Colorectal surgery / Critical care · teaching

Acute Colonic Pseudo-Obstruction (Ogilvie) Pathway · case challenge

Given a case, work through the care pathway step by step; the tool checks each choice and scores you. Decisions and basis are taken from this site's reviewed care pathways.

← View the full flowchartBased on ASGE / NEJM

Case #1Gastroenterology / Colorectal surgery / Critical care

📋 Case data

Ischemia/perforation?No ischemia/perforation (conservative/neostigmine first)

Data is taken from this pathway's reviewed node text. Work through the pathway step by step.

Step 1 / 1 · Ischemia/perforation?

Ischemia/perforation/peritonitis; response to 24–48 h of conservative care?

💡 Acute colonic pseudo-obstruction (Ogilvie) = massive colonic dilation (especially cecum/right colon) without mechanical obstruction, from autonomic imbalance; common in hospitalized/postoperative (cesarean, orthopedic)/critically ill/electrolyte disturbance/drugs (opioids, anticholinergics). Perforation risk rises with cecal diameter: <12 cm ~0%, 12–14 cm ~7%, >14 cm ~23%. Diagnosis: plain film (cecal dilation), CT + oral/rectal contrast to exclude mechanical obstruction, check for ischemia/perforation.

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.