Functional pathology of the adult, very rarely observed in childhood (differential diagnosis: Hirchsprung disease). Clinical presentation of occlusion of the digestive tract with acute dilation of the colon and cecum in the absence of any intrinsic, extrinsic, or inflammatory organic cause.

Predisposing factors: postoperative period, fragile patient (severely burned, respiratory failure), hypokalemia, large doses of morphine and/or anticholinergic drugs.

Risk of colonic perforation.

Treatment: decompressive colonoscopy and medical treatment (potassium, antibiotics, rehydration ...). Neostigmine and antagonists of the µ peripheral opioid receptors should be used with caution.

Anesthetic implications:

full stomach, abdominal distension, ionic disturbances, hypovolemia

References:

-        Blackney KA, Kamdar NV, Liu CA, Edwards DA.
Methylnaltrexone-associated bowel perforation in postoperative opioid-induced constipation and Ogilvie syndrome: a case report.
A&A Practice 2019; 12: 44-6

Updated: January 2019