小児脊髄変形手術後のオギルビー症候群：ネオスティグミンによる治療の成功

Ogilvieの症候群は、術後のイレウスと簡単に間違える可能性があるまれで潜在的に致命的な病気です。急性結腸擬似閉塞としても知られている症候群の早期認識と診断により、腸の穿孔と必要な腹部手術の前に治療が可能になります。著者らは、急性腹部膨張、吐き気、術後の日に急性腹部膨張、吐き気、嘔吐を呈した思春期の脊髄変形矯正とテザーコード放出後のオギルビー症候群の症例を報告しています。この治療にもかかわらず、彼女の臨床経過は改善に失敗し、彼女は有意な結腸膨張を放射線学的に示しました。静脈内ネオスチグミンは、迅速で劇的な反応を伴うボーラスとして投与されました。この症例は、小児神経外科手術後のオギルビー症候群治療におけるネオスチグミン使用の最初の報告された例です。

Ogilvie's syndrome is a rare and potentially fatal disease that can easily be mistaken for postoperative ileus. Also known as acute colonic pseudo-obstruction, early recognition and diagnosis of the syndrome allows for treatment prior to bowel perforation and requisite abdominal surgery. The authors report a case of Ogilvie's syndrome following spinal deformity correction and tethered cord release in an adolescent who presented with acute abdominal distension, nausea, and vomiting on postoperative Day 0. The patient was initially diagnosed with adynamic ileus and treated conservatively with bowel rest, reduction in narcotic dosage, and a regimen of stool softeners, laxatives, and enemas. Despite this treatment, her clinical course failed to improve, and she demonstrated significant colonic distension radiographically. Intravenous neostigmine was administered as a bolus with a rapid and dramatic response. This case is the first reported instance of neostigmine use for Ogilvie's syndrome treatment following a pediatric neurosurgical operation.