Ogilvie's syndrome: a new approach to an old problem.

PURPOSE: This study was designed to determine the value of intravenous neostigmine in achieving adequate colonic decompression in patients with Ogilvie's syndrome.

METHODS: A prospective study was undertaken in 12 consecutive patients (median age, 60 (range, 38-98) years) with contrast enema-proven Ogilvie's syndrome (median duration, four (range, two-nine) days)

RESULTS: Satisfactory clinical decompression of large bowel distention was attained in 11 patients, although one required colectomy for subsequent recurrence and ischemia.

CONCLUSION: These results support the theory that many cases of Ogilvie's syndrome are the result of excessive large bowel parasympathetic suppression rather than sympathetic overactivity.