Acute colonic pseudo-obstruction (Ogilvie syndrome) after arthroplasty in the lower extremity

Joshua D. Nelson, Joshua A. Urban, Thomas L. Salsbury, Jason K. Lowry, Kevin Lloyd Garvin

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: Acute colonic pseudo-obstruction, also known as Ogilvie syndrome, is an uncommon postoperative complication of total hip and total knee arthroplasty that is characterized by massive colonic dilatation and the potential for substantial morbidity and mortality. Methods: We conducted a retrospective case-control study of 1170 total hip and knee arthroplasties performed by one surgeon from 1995 to 2002, and identified eighteen patients with Ogilvie syndrome. Radiographs and medical records were analyzed for risk factors and treatment effectiveness. Results: Eleven (1.6%) of 708 patients who had a total hip arthroplasty and seven (1.5%) of 462 patients who had a total knee arthroplasty had Ogilvie syndrome develop postoperatively. Seventeen of these patients had preoperative conditions and/or had received medications identified as risk factors for Ogilvie syndrome. The use of patient-controlled analgesia was associated with an earlier development of symptoms. Colonic decompression was performed in seven patients and was associated with a significantly shorter hospital stay (p = 0.019). Conclusions: Acute colonic pseudo-obstruction was equally prevalent after total hip and total knee arthroplasties. Most patients who had Ogilvie syndrome had risk factors that could be identified preoperatively. Knowledge of these risk factors can enable the physician to anticipate which patients may have Ogilvie syndrome develop and, therefore, to be vigilant for its development and judicious in the use of patient-controlled analgesia. We also found that decompressive colonoscopy reduced the risk of perforation and decreased the length of hospitalization for the patients in whom Ogilvie syndrome developed. Level of Evidence: Prognostic Level III.

Original languageEnglish (US)
Pages (from-to)604-610
Number of pages7
JournalJournal of Bone and Joint Surgery - Series A
Volume88
Issue number3
DOIs
StatePublished - Mar 1 2006

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Colonic Pseudo-Obstruction
Arthroplasty
Lower Extremity
Knee Replacement Arthroplasties
Hip
Patient-Controlled Analgesia
Colonoscopy
Decompression
Medical Records
Case-Control Studies
Dilatation
Length of Stay
Hospitalization

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Acute colonic pseudo-obstruction (Ogilvie syndrome) after arthroplasty in the lower extremity. / Nelson, Joshua D.; Urban, Joshua A.; Salsbury, Thomas L.; Lowry, Jason K.; Garvin, Kevin Lloyd.

In: Journal of Bone and Joint Surgery - Series A, Vol. 88, No. 3, 01.03.2006, p. 604-610.

Research output: Contribution to journalArticle

Nelson, Joshua D. ; Urban, Joshua A. ; Salsbury, Thomas L. ; Lowry, Jason K. ; Garvin, Kevin Lloyd. / Acute colonic pseudo-obstruction (Ogilvie syndrome) after arthroplasty in the lower extremity. In: Journal of Bone and Joint Surgery - Series A. 2006 ; Vol. 88, No. 3. pp. 604-610.
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