Nonoperative management of acute idiopathic colonic pseudo-obstruction (Ogilvie's syndrome).

In a four-year experience (35 episodes in 27 patients) with the use of medical and colonoscopic therapy for acute idiopathic colonic pseudo-obstruction, we have found that initial conservative measures followed by flexible colonoscopy in nonresponders are effective and safe. Contrary to previous reports, an initial nonoperative approach including colonscopy is frequently successful and the outcome with this approach is not adversely affected even in the few patients who eventually require surgical decompression.