Acute Colonic Pseudo-obstruction (Ogilvies Syndrome) in Thalamic Hemorrhage
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Abstract
Ogilvies syndrome, also known as acute colonic pseudo-obstruction (ACPO), is a severe side effect of numerous neurological conditions, notably parkinsonism, dementia stoke, and spinal cord injury. A 55 years old man on the third day of left thalamic hemorrhage developed ACPO. He had severe pain, abdominal distension, and reduced bowel sounds. His abdominal radiograph revealed air fluid levels and computerized tomography dilated bowel loops. He was treated with intravenous fluids and nasogastric suction but because of his worsening condition on day nine, he was prescribed inj neostigmine 2 mg IM. He responded by passing large amount of flatus within one hour of injection. His serum Catecholamine levels declined on day 15 (Serum dopamine on day 5 and 15 was 92.5 and 19.8 μg/L, epinephrine 47.8 and 19.8 μg/L and nor epinephrine 64.2 and 32.2 μg/L, respectively) suggesting the role of increased sympathetic activity in ACPO.
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