F. Tureganofuentes et al., EARLY RESOLUTION OF OGILVIES-SYNDROME WITH INTRAVENOUS NEOSTIGMINE - A SIMPLE, EFFECTIVE TREATMENT, Diseases of the colon & rectum, 40(11), 1997, pp. 1353-1357
PURPOSE: Our aim was to assess the value of a parasympathomimetic drug
(neostigmine) in the early resolution of acute colonic pseudo-obstruc
tion (Ogilvie's syndrome). METHODS: A prospective study was undertaken
in 18 consecutive patients (mean age, 76 (range, 31-87) years) with a
cute colonic pseudo-obstruction. After a varying period of conservativ
e treatment in all cases, IG patients with persistent, massive abdomin
al distention were given intravenous neostigmine. RESULTS: A rapid and
satisfactory clinical and radiologic decompression of the large bowel
was obtained in 12 patients (75 percent) after a single dose of the d
rug; another patient had complete resolution after a second dose, and
the other 3 patients had only partial resolution, in one of them after
a second dose of the drug. No patient required surgical decompression
of the bowel. CONCLUSION: These results give support to the theory of
excessive parasympathetic suppression in most cases of Ogilvie's synd
rome. The treatment with intravenous neostigmine has proved very effec
tive, preventing in many cases prolonged periods of uncomfortable and
potentially hazardous conventional conservative management and avoidin
g surgical treatment in a consecutive series of patients.