Triple Trouble: Colonic Obstruction by Sigmoid Volvulus in a Patient Affected by Ogilvie Syndrome and Giant Bochdalek Hernia

Author Info

Federico Marchesi Filippo Montali Gerardo Palmieri Renato Costi

Corresponding Author

Renato Costi
Unità Operativa di Chirurgia Generale, Ospedale di Vaio, Fidenza (Parma), Azienda Sanitaria Locale di Parma, Parma, Italia

A B S T R A C T

Bochdalek hernia is a congenital left diaphragmatic hernia (CDH), usually diagnosed in children following the onset of thoracic symptoms such as dyspnea or tachycardia. Ogilvie’s syndrome (or acute colonic pseudo-obstruction) may be due to several conditions, including neurologic diseases, neuroleptic therapy and systemic syndromes, and is characterized by massive colon dilation in the absence of mechanical obstruction or toxic mega-colon. Sigmoid volvulus, consisting of sigmoid rotation around its axis, is a relatively frequent cause of large bowel obstruction. The three simultaneous conditions in the same patient in an emergency setting are rare, leading to a challenging situation concerning diagnosis and management. Here, we report the case of a mentally disabled 59-year-old female presenting with colonic obstruction caused by sigmoid volvulus after several episodes of Ogilvie’s syndrome-related pseudo-occlusion, found to have a giant left-sided Bochdalek diaphragmatic hernia. The patient was treated by an emergency laparoscopic approach. Despite the resolution of the abdominal picture, the patient died on postoperative day 15 by respiratory failure.

Article Info

Article Type

Case Report

Publication history

Received: Mon 27, Apr 2020
Accepted: Mon 25, May 2020
Published: Fri 05, Jun 2020

Copyright

© 2023 Renato Costi. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.SCR.2020.05.12