Limits...
Ogilvie's syndrome following posterior spinal instrumentation in thoraco lumbar trauma.

Krishnakumar R, Kuzhimattam MJ, Kumar G - J Craniovertebr Junction Spine (2015 Oct-Dec)

Bottom Line: Computed tomography scans ruled out the mechanical obstruction.All patients improved with conservative management.Early recognition and appropriate conservative treatment would be necessary to prevent complications such as bowel ischemia and perforation.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Spine Division, Amrita Institute of Medical Sciences, Cochin, Kerala, India.

ABSTRACT

Objectives: To report unique cases of Ogilvie's syndrome (acute intestinal pseudo-obstruction) following posterior spinal instrumentation in thoraco lumbar trauma.

Materials and methods: A single centre retrospective study. We reviewed the surgical data of 420 patients who underwent thoracolumbar spinal surgery over a period of four years. Two patients who developed post operative Ogilvie's syndromes were identified.

Results: The clinical presentation and blood investigations ruled out any infectious pathology. Computed tomography scans ruled out the mechanical obstruction. All patients improved with conservative management.

Conclusion: Ogilvie's syndrome should be considered as a differential diagnosis in patients with postoperative significant abdominal distension who had undergone posterior instrumentation for spinal trauma. Early recognition and appropriate conservative treatment would be necessary to prevent complications such as bowel ischemia and perforation.

No MeSH data available.


Related in: MedlinePlus

Computed tomography scan of first patient showing dilated intestinal loops
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4660494&req=5

Figure 5: Computed tomography scan of first patient showing dilated intestinal loops

Mentions: Retrospective analysis of single center surgical data of patients undergoing thoracolumbar instrumented spinal fusion from January 2010 to December 2013. Of the 420 patients who had undergone thoracolumbar spine surgery, two patients developed postoperative Ogilvie's syndrome. First had burst fracture (Type C) of T-12 vertebrae with kyphosis [Figure 1], second with Type B fracture L-1 vertebrae and split fracture of L-5 vertebrae [Figure 2]. Both patients were neurologically preserved with intact bowel and bladder function. Both patients underwent posterior instrumented spine surgery within 48 h. In addition, transpedicular grafting was done for the first patient [Figures 3 and 4]. On the second postoperative day, both patients developed significant abdominal distension and abdominal pain. On examination, abdomens were firm, and bowel sounds were absent with tympanic abdomen. Laboratory values were within normal limits. Computed tomography scan was done for both patients on the same day, which demonstrated dilation of the large intestine [Figures 5 and 6]. Gastromedicine consultation was sought, and both patients were diagnosed to have Ogilvie's syndrome. Both patients were kept nil per orally (NPO) with serial measurement of abdominal girth and serum electrolytes monitoring. Bowel decompression with Ryle's tube and flatus tube were done with the maintenance of adequate hydration. The abdominal distention and symptoms improved in 4 days, and both were discharged on day 7.


Ogilvie's syndrome following posterior spinal instrumentation in thoraco lumbar trauma.

Krishnakumar R, Kuzhimattam MJ, Kumar G - J Craniovertebr Junction Spine (2015 Oct-Dec)

Computed tomography scan of first patient showing dilated intestinal loops
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660494&req=5

Figure 5: Computed tomography scan of first patient showing dilated intestinal loops
Mentions: Retrospective analysis of single center surgical data of patients undergoing thoracolumbar instrumented spinal fusion from January 2010 to December 2013. Of the 420 patients who had undergone thoracolumbar spine surgery, two patients developed postoperative Ogilvie's syndrome. First had burst fracture (Type C) of T-12 vertebrae with kyphosis [Figure 1], second with Type B fracture L-1 vertebrae and split fracture of L-5 vertebrae [Figure 2]. Both patients were neurologically preserved with intact bowel and bladder function. Both patients underwent posterior instrumented spine surgery within 48 h. In addition, transpedicular grafting was done for the first patient [Figures 3 and 4]. On the second postoperative day, both patients developed significant abdominal distension and abdominal pain. On examination, abdomens were firm, and bowel sounds were absent with tympanic abdomen. Laboratory values were within normal limits. Computed tomography scan was done for both patients on the same day, which demonstrated dilation of the large intestine [Figures 5 and 6]. Gastromedicine consultation was sought, and both patients were diagnosed to have Ogilvie's syndrome. Both patients were kept nil per orally (NPO) with serial measurement of abdominal girth and serum electrolytes monitoring. Bowel decompression with Ryle's tube and flatus tube were done with the maintenance of adequate hydration. The abdominal distention and symptoms improved in 4 days, and both were discharged on day 7.

Bottom Line: Computed tomography scans ruled out the mechanical obstruction.All patients improved with conservative management.Early recognition and appropriate conservative treatment would be necessary to prevent complications such as bowel ischemia and perforation.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Spine Division, Amrita Institute of Medical Sciences, Cochin, Kerala, India.

ABSTRACT

Objectives: To report unique cases of Ogilvie's syndrome (acute intestinal pseudo-obstruction) following posterior spinal instrumentation in thoraco lumbar trauma.

Materials and methods: A single centre retrospective study. We reviewed the surgical data of 420 patients who underwent thoracolumbar spinal surgery over a period of four years. Two patients who developed post operative Ogilvie's syndromes were identified.

Results: The clinical presentation and blood investigations ruled out any infectious pathology. Computed tomography scans ruled out the mechanical obstruction. All patients improved with conservative management.

Conclusion: Ogilvie's syndrome should be considered as a differential diagnosis in patients with postoperative significant abdominal distension who had undergone posterior instrumentation for spinal trauma. Early recognition and appropriate conservative treatment would be necessary to prevent complications such as bowel ischemia and perforation.

No MeSH data available.


Related in: MedlinePlus