[Ogilvie syndrome or acute colonic pseudo-obstruction. Current concepts in diagnosis and treatment].

Ogilvie's syndrome or acute colonic pseudo-obstruction is a motility disorder characterized by acute and progressive colonic distension. This syndrome occurs in hospitalized patients with several medical or surgical diseases with an unclear pathophysiology. Diagnosis is established by the clinical history, physical examination and radiological findings on plain abdominal X-ray. Treatment includes: 1. general measures to reduce colonic distension, 2. drugs that improve colon motility, 3. endoscopic colonic decompression and 4. surgery. Age, associated diseases, elapsed time and diameter of cecal dilatation, presence of necrosis and perforation are the main prognostic factors. Recurrence after medical treatment is 20-50 percent; intrahospital mortality is 30 percent. A practical algorithm for the management of these patients is proposed.