From the classroom to the emergency room, O.R. and beyond. You're joining Trauma ICU Rounds with your host, Dr. Dennis Kim.

Welcome back to trauma ICU rounds. I'm your host, Dennis Kim. Earlier this week, we had several fantastic guest professors join us on rounds to discuss the management

of the difficult gallbladder.

And I wanted to give it big shout out to Dr. Sharmila DeSanaki, Michael Truitt, Jessica

Keeley, Angela Neville, and Dr. Christian D'Virgilio for joining us and sharing their thoughts

and approach to performing a subtotal

colostectomy versus converting to an open colostectomy. Be sure to check out that episode dropping

later this week. Given that the focus of our last rounds was acute mesenteric ischemia with

a primary focus on the small bowel, today I thought we'd

move down the GI tract and discussed acute colonic pseudo- obstruction, aka A. Dynamic Ilius of the

colon, also known as Ogilvy's syndrome. Now, although operative intervention is seldomly

required for this particular disease process,

it's amazing how often as surgeons were consulted to assess a patient with a quote-unquote

dilated colon on abdominal x-ray or CT.

With that said, if left unrecognized and untreated, progressive and prolonged colonic distension may progress to,

you guessed it, colonic ischemia and eventually perforation.

Regarding learning objectives, by the end of rounds, you should be able to, number one,

discuss the proposed mechanisms and risk factors for acute colonic

pseudo obstruction. Number two, recognize the clinical manifestations of this disease.

Three, initiate an appropriate and safe workup for Ogilvy syndrome while ruling out other

causes of colonic distension, and finally you should understand

the stepwise pharmacologic and non-pharmacologic approach to management of this condition.

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