Mehmet Berksun TUTAN, Veysel Barış TURHAN
Turkish Journal of Colorectal Disease - 2026;36(1):27-31
Ogilvie's syndrome, or acute colonic pseudo-obstruction, is a rare but potentially life-threatening condition characterized by massive colonic dilatation in the absence of mechanical obstruction. It predominantly affects elderly and postoperative patients. Cases in younger individuals who are neurologically impaired remain exceedingly rare. We report a 39-year-old man with severe intellectual disability and lifelong immobility who presented with progressive abdominal distension and no defecation for 72 hours. Computed tomography imaging revealed diffuse colonic dilatation with a cecal diameter of 9.2 cm. Mechanical obstruction was excluded. Due to the unavailability of neostigmine, the patient was managed conservatively using nasogastric decompression, rectal tube placement, and intravenous metoclopramide. Substantial clinical improvement occurred within 24 hours, with the complete resolution of symptoms by day 4. The patient was discharged with a structured bowel regimen and showed no recurrence at early follow-up. Informed consent for publication was obtained from the patient's legal guardians prior to the writing of this case report. This case highlights a rare presentation of Ogilvie's syndrome in a young adult with neurodevelopmental impairment and demonstrates that non-pharmacological conservative treatment may be sufficient in the absence of neostigmine.
