Ogilvie's syndrome after lower extremity arthroplasty

OBJECTIVE: To alert surgeons who perform arthroplasty to the possibility of acute colonic pseudo-obstruction (Ogilvie's syndrome) after elective ortho pedic procedures. To identify possible risk factors and emphasize the need for prompt recognition, careful monitoring and appropriate management so as to reduce morbidity and mortality, DESIGN: A case series, SETTING: A university-affiliated hospital that is a major referral centre f or orthopedic surgery. PATIENTS: Four patients who had Ogilvie's syndrome after lower extremity ar throplasty, Of this group, 2 had primary hip arthroplasty, 1 had primary kn ee arthroplasty and 1 had revision hip arthroplasty. MAIN OUTCOME MEASURES: Morbidity and mortality. RESULTS: In all 4 patients Ogilvie's syndrome was recognized late and requi red surgical intervention. Two patients died as a result of postoperative c omplications, CONCLUSIONS: Our case series identified increasing age, immobility and pati ent-controlled narcotic analgesia as potential risk factors for Ogilvie's s yndrome in the postoperative orthopedic patient. Prompt recognition and ear ly consultation with frequent clinical and radiographic monitoring are nece ssary to avoid colonic perforation and its significant associated death rat e.