Ogilvie’s Syndrome (Acute Colonic Pseudo-Obstruction): CT Imaging Diagnosis, Emergency Management, and Radiology Insights
Ogilvie’s Syndrome: The Critical CT Diagnosis Every Radiologist and Emergency Physician Should Recognize Acute abdominal distension is one of the most challenging presentations in emergency medicine. While mechanical bowel obstruction is often suspected first, some patients present with dramatic colonic dilatation despite the absence of a physical blockage. This condition is known as Ogilvie’s syndrome , or Acute Colonic Pseudo-Obstruction (ACPO) . Although uncommon, delayed diagnosis can result in bowel ischemia, perforation, sepsis, and death. Modern medical imaging , especially CT scan diagnosis , plays a central role in identifying the condition before catastrophic complications occur. In this article, we review the pathophysiology, epidemiology, imaging findings, differential diagnosis, treatment options, and prognosis of Ogilvie’s syndrome through a real-world clinical case. A Clinical Story: When Abdominal Distension Became an Emergency A 54-year-old woman with end-stage liver d...