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Ogilvie's Syndrome: A True Definition

ROBERT R. M. GIFFORD, MD
Arch Surg. 1987;122(8):958. doi:10.1001/archsurg.1987.01400200108027.
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To the Editor.—In a recent issue of the Archives, Drs Evans and Brotman1 described a case of Ogilvie's syndrome following traumatic rupture of the thoracic aorta. The term Ogilvie's syndrome has been applied to an assortment of conditions associated with nonobstructive colonic distention, quite possibly in an all-too-generous fashion.

In 1948, Sir Heneage Ogilvie described two cases of colonic distention associated with extensive malignant tumor invasion of the subdiaphragmatic sympathetic plexus.2 He felt that the interruption of the sympathetic neural innervation of the colon allowed for unopposed parasympathetic innervation, which for the distal colon comes from the second and third sacral nerves. Thus, in a true historical sense, Ogilvie's syndrome is nonobstructive colonic distention associated with tumor infiltration resulting in a sympathetic/parasympathetic neural imbalance.

A number of clinical presentations have been generically described as pseudo-obstruction of the colon and have been associated with a variety of factors,

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