A Case of Acute Colonic Pseudo-obstruction (Ogilvie Syndrome) after Laparoscopic Surgery

Abstract

A 69-year-old male suffered from nausea and abdominal fullness. Our examination revealed descending colon cancer with stenosis. After decompression with a transanal drainage tube, laparoscopic resection of the descending colon was performed. After surgery, abdominal fullness and ileus developed, and an imaging study showed colonic dilation at the oral side of the anastomosis. Conservative treatment with an ileus tube had no effect, so surgery was performed 23 days postoperatively due to the possibility of adhesive obstruction. Since the small intestine, colon, and anastomosis were found to have no obstruction during surgery, an artificial anus was constructed on the dilated transverse colon. After reoperation, we suspected acute colonic pseudo-obstruction (ACPO) and started drug treatment. However, surgery was needed because cholecystitis occurred. After cholecystectomy, administration of drugs and pressure reduction improved ACPO. There are some reports of ACPO after laparotomy, but it is very rare after laparoscopic surgery. However, we believe that post-laparoscopic ACPO cases are becoming more common over time.