Acute Colonic Pseudoobstruction (Acute Megacolon, Ogilvie Syndrome) Differential Diagnoses

Updated: Jan 24, 2020
  • Author: Roberto M Gamarra, MD; Chief Editor: BS Anand, MD  more...
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Diagnostic Considerations

It is important for clinicians to recognize and diagnose acute colonic pseudoobstruction (ACPO) (acute megacolon, Ogilvie syndrome) when patients present with typical symptoms of abdominal pain and distention and physical examination reveals tympanitic percussion. Imaging studies should be performed to establish the diagnosis. Mortality is associated with colonic ischemia and spontaneous perforation of nontoxic megacolon.

Also consider intestinal/colonic obstruction in the differential diagnosis (eg, malignancy, volvulus, intussusception, fecal impaction, rectal prolapse, foreign body).

Differential Diagnoses