ICD-10: K59.81

Ogilvie syndrome

Clinical Information

Inclusion Terms

  • Acute colonic pseudo-obstruction (ACPO)

Additional Information

Approximate Synonyms

Ogilvie syndrome, classified under the ICD-10-CM code K59.81, is a condition characterized by acute colonic pseudo-obstruction. This syndrome can lead to significant gastrointestinal complications if not managed appropriately. Below are alternative names and related terms associated with Ogilvie syndrome.

Alternative Names for Ogilvie Syndrome

  1. Acute Colonic Pseudo-Obstruction: This is the most common alternative name, emphasizing the condition's nature of mimicking a mechanical obstruction without any physical blockage present.

  2. Ogilvie's Syndrome: A variation of the name that includes the possessive form, often used interchangeably with Ogilvie syndrome.

  3. Colonic Pseudo-Obstruction: A broader term that can refer to similar conditions affecting the colon, not necessarily limited to Ogilvie syndrome.

  4. Non-Mechanical Colonic Obstruction: This term highlights the absence of a physical obstruction, which is a key feature of Ogilvie syndrome.

  5. Functional Colonic Obstruction: This term is used to describe the functional aspect of the syndrome, where the colon fails to function properly despite the absence of a structural blockage.

  1. Ileus: While not synonymous, ileus refers to a similar condition where there is a lack of movement in the intestines, which can lead to obstruction-like symptoms.

  2. Bowel Obstruction: A general term that encompasses both mechanical and non-mechanical causes of obstruction in the intestines.

  3. Gastrointestinal Motility Disorders: This term includes a range of conditions that affect the movement of the gastrointestinal tract, of which Ogilvie syndrome is a specific example.

  4. Functional Intestinal Disorders: A category that includes various disorders affecting intestinal function, including Ogilvie syndrome, which is classified under K59.8 in the ICD-10-CM.

  5. Neostigmine Treatment: Referring to a therapeutic approach often used in managing Ogilvie syndrome, where neostigmine is administered to stimulate bowel motility.

Conclusion

Understanding the alternative names and related terms for Ogilvie syndrome is crucial for healthcare professionals involved in diagnosis and treatment. These terms help in accurately communicating the condition and its implications in clinical settings. If you need further information on treatment options or management strategies for Ogilvie syndrome, feel free to ask!

Diagnostic Criteria

Ogilvie syndrome, also known as acute colonic pseudo-obstruction, is a condition characterized by the dilation of the colon without any mechanical obstruction. The diagnosis of Ogilvie syndrome (ICD-10 code K59.81) involves a combination of clinical evaluation, imaging studies, and exclusion of other potential causes of colonic distension. Here’s a detailed overview of the criteria used for diagnosing this syndrome.

Clinical Criteria

  1. Symptoms: Patients typically present with symptoms such as abdominal distension, pain, nausea, vomiting, and constipation. These symptoms may mimic those of a mechanical bowel obstruction, which is a critical consideration in the differential diagnosis.

  2. Physical Examination: A thorough physical examination may reveal abdominal tenderness, distension, and the absence of bowel sounds. The presence of these signs can help differentiate Ogilvie syndrome from other gastrointestinal conditions.

Diagnostic Imaging

  1. Abdominal X-ray: An initial imaging study often includes an abdominal X-ray, which can show colonic dilation. The absence of air-fluid levels in the colon suggests that there is no mechanical obstruction.

  2. CT Scan: A computed tomography (CT) scan of the abdomen is more definitive. It can provide detailed images of the colon and help rule out other causes of colonic distension, such as tumors or strictures. The CT scan may also show the characteristic findings of colonic dilation without obstruction.

  3. Ultrasound: In some cases, abdominal ultrasound may be used to assess bowel distension and to evaluate for other abdominal pathologies.

Exclusion of Other Conditions

  1. Mechanical Obstruction: A key aspect of diagnosing Ogilvie syndrome is the exclusion of mechanical obstruction. This is typically done through imaging studies that confirm the absence of a physical blockage in the colon.

  2. Other Causes of Colonic Distension: Conditions such as inflammatory bowel disease, ischemia, or malignancy must be ruled out. This may involve additional tests or imaging studies based on the clinical scenario.

Additional Considerations

  1. Underlying Conditions: Ogilvie syndrome is often associated with underlying medical conditions, such as recent surgery, trauma, or certain medications (e.g., opioids). A thorough medical history is essential to identify these factors.

  2. Laboratory Tests: While not specific for Ogilvie syndrome, laboratory tests may be performed to assess for electrolyte imbalances or signs of infection, which can influence management.

Conclusion

The diagnosis of Ogilvie syndrome (ICD-10 code K59.81) relies on a combination of clinical symptoms, imaging studies, and the exclusion of other gastrointestinal disorders. A careful assessment is crucial to ensure appropriate management and to avoid unnecessary interventions. If you suspect Ogilvie syndrome, it is essential to consult with a healthcare professional for a comprehensive evaluation and diagnosis.

Treatment Guidelines

Ogilvie syndrome, also known as acute colonic pseudo-obstruction, is a condition characterized by the dilation of the colon without any mechanical obstruction. It is often seen in hospitalized patients, particularly those who are elderly or have underlying medical conditions. The ICD-10 code for Ogilvie syndrome is K59.81. Here, we will explore the standard treatment approaches for this condition, including both medical and surgical options.

Understanding Ogilvie Syndrome

Ogilvie syndrome can occur due to various factors, including medications, electrolyte imbalances, and underlying diseases such as infections or neurological disorders. The condition can lead to significant complications, including colonic perforation, if not managed appropriately. Therefore, timely diagnosis and treatment are crucial.

Standard Treatment Approaches

1. Initial Assessment and Monitoring

Before initiating treatment, a thorough assessment is essential. This includes:

  • Clinical Evaluation: Assessing symptoms such as abdominal distension, pain, and bowel habits.
  • Imaging Studies: Abdominal X-rays or CT scans may be performed to confirm colonic dilation and rule out mechanical obstruction.
  • Laboratory Tests: Checking for electrolyte imbalances, renal function, and signs of infection.

2. Conservative Management

In many cases, conservative management is the first line of treatment:

  • Bowel Rest: Patients are typically advised to refrain from oral intake to reduce bowel activity.
  • Fluid and Electrolyte Management: Intravenous fluids may be administered to correct any electrolyte imbalances and maintain hydration.
  • Medications:
  • Prokinetic Agents: Medications such as metoclopramide or erythromycin may be used to stimulate bowel motility.
  • Neostigmine: This acetylcholinesterase inhibitor has been shown to be effective in treating Ogilvie syndrome by enhancing colonic motility. It is administered subcutaneously or intravenously and can lead to rapid improvement in symptoms[3][8].

3. Endoscopic Intervention

If conservative measures fail, endoscopic intervention may be considered:

  • Colonoscopy: This can be used not only for diagnostic purposes but also for therapeutic interventions, such as decompression of the colon. In some cases, the passage of the colonoscope can help relieve the obstruction by stimulating peristalsis.

4. Surgical Options

Surgery is generally reserved for severe cases or when there is a risk of complications:

  • Surgical Decompression: If there is significant colonic dilation or signs of perforation, surgical intervention may be necessary. This can involve resection of the affected segment or colostomy in extreme cases.
  • Exploratory Laparotomy: In cases where the cause of the obstruction is unclear, a surgical exploration may be warranted to identify and address any underlying issues.

5. Post-Treatment Care

After treatment, ongoing monitoring is essential to prevent recurrence:

  • Dietary Modifications: Gradual reintroduction of oral intake, starting with clear liquids and progressing as tolerated.
  • Follow-Up Imaging: To ensure resolution of colonic dilation and monitor for any complications.

Conclusion

Ogilvie syndrome requires a multifaceted approach to treatment, starting with conservative management and progressing to more invasive interventions as necessary. The use of medications like neostigmine has shown promise in enhancing colonic motility, while endoscopic and surgical options are available for more severe cases. Early recognition and appropriate management are key to preventing complications associated with this condition. If you suspect Ogilvie syndrome, it is crucial to consult a healthcare professional for a tailored treatment plan.

Description

Ogilvie syndrome, also known as acute colonic pseudo-obstruction, is a condition characterized by the dilation of the colon without any mechanical obstruction. This syndrome is often seen in hospitalized patients and can lead to significant complications if not recognized and treated promptly. Below is a detailed clinical description and relevant information regarding ICD-10 code K59.81, which specifically pertains to Ogilvie syndrome.

Clinical Description of Ogilvie Syndrome

Definition

Ogilvie syndrome is defined as a functional disorder of the colon that results in massive colonic distension. Unlike typical bowel obstructions, there is no physical blockage; instead, the motility of the colon is impaired, leading to an accumulation of gas and fecal material.

Etiology

The exact cause of Ogilvie syndrome is often multifactorial and can include:
- Postoperative states: Particularly after abdominal or pelvic surgery.
- Neurological conditions: Such as spinal cord injuries or multiple sclerosis.
- Metabolic disturbances: Including electrolyte imbalances, particularly hypokalemia.
- Medications: Opioids and anticholinergic drugs can contribute to decreased bowel motility.
- Severe illness: Conditions such as sepsis or pneumonia can precipitate the syndrome.

Symptoms

Patients with Ogilvie syndrome may present with:
- Abdominal distension and discomfort.
- Nausea and vomiting.
- Constipation or obstipation (severe constipation).
- Abdominal pain, which may be crampy in nature.
- Changes in bowel habits.

Diagnosis

Diagnosis is primarily clinical, supported by imaging studies. Key diagnostic steps include:
- Physical examination: Noting abdominal distension and tenderness.
- Radiological imaging: An abdominal X-ray or CT scan can reveal colonic dilation without obstruction.
- Exclusion of mechanical obstruction: It is crucial to rule out other causes of colonic distension.

Treatment

Management of Ogilvie syndrome may involve:
- Conservative measures: Such as bowel rest, hydration, and electrolyte correction.
- Medications: Neostigmine, a cholinesterase inhibitor, can be effective in stimulating colonic motility.
- Decompression: In severe cases, decompressive colonoscopy or surgical intervention may be necessary to relieve distension and prevent complications like perforation.

ICD-10 Code K59.81

Code Details

  • ICD-10 Code: K59.81
  • Description: Ogilvie syndrome
  • Classification: This code falls under the category of "Other specified functional intestinal disorders" (K59.8) in the ICD-10-CM coding system, which is used for billing and documentation purposes in healthcare settings.

Importance of Accurate Coding

Accurate coding of Ogilvie syndrome is essential for:
- Clinical documentation: Ensuring that the condition is properly recorded in medical records.
- Insurance reimbursement: Facilitating appropriate billing for treatments and interventions.
- Epidemiological tracking: Assisting in the understanding of the incidence and prevalence of the syndrome in various populations.

Conclusion

Ogilvie syndrome is a significant clinical condition that requires prompt recognition and management to prevent serious complications. The ICD-10 code K59.81 is crucial for accurately documenting this syndrome in medical records and ensuring appropriate treatment pathways are followed. Understanding the clinical features, diagnostic criteria, and management strategies is essential for healthcare providers dealing with patients at risk for this condition.

Clinical Information

Ogilvie syndrome, also known as acute colonic pseudo-obstruction, is a condition characterized by the dilation of the colon without any mechanical obstruction. This syndrome can lead to significant gastrointestinal complications if not recognized and treated promptly. Below is a detailed overview of the clinical presentation, signs, symptoms, and patient characteristics associated with Ogilvie syndrome.

Clinical Presentation

Ogilvie syndrome typically presents in patients with a history of underlying medical conditions, particularly those affecting the nervous system or those who have undergone recent surgery. The condition is often seen in hospitalized patients, especially the elderly or those with significant comorbidities.

Signs and Symptoms

  1. Abdominal Distension: One of the hallmark signs of Ogilvie syndrome is significant abdominal distension, which may be visibly noticeable and can cause discomfort to the patient[12][13].

  2. Abdominal Pain: Patients often report varying degrees of abdominal pain, which can range from mild discomfort to severe cramping. The pain is usually diffuse rather than localized[12][13].

  3. Nausea and Vomiting: Many patients experience nausea, and some may have episodes of vomiting, which can be attributed to the buildup of intestinal contents[12][13].

  4. Constipation: A notable symptom is constipation, as the colonic motility is impaired, leading to difficulty in passing stool[12][13].

  5. Bowel Sounds: On examination, bowel sounds may be diminished or absent, indicating reduced intestinal activity[12][13].

  6. Signs of Dehydration: In severe cases, patients may exhibit signs of dehydration due to prolonged vomiting or inability to maintain oral intake[12][13].

Patient Characteristics

Ogilvie syndrome is more commonly observed in specific patient populations:

  • Age: The condition predominantly affects older adults, particularly those over the age of 60[12][13].
  • Comorbidities: Patients with underlying conditions such as diabetes, neurological disorders (e.g., Parkinson's disease), or those who have undergone recent abdominal or pelvic surgery are at higher risk[12][13].
  • Medications: Use of certain medications, particularly opioids and anticholinergics, can contribute to the development of Ogilvie syndrome by impairing gastrointestinal motility[12][13].
  • Hospitalization: The syndrome is frequently seen in hospitalized patients, especially those in intensive care units, due to factors like immobility, electrolyte imbalances, and the effects of anesthesia[12][13].

Conclusion

Ogilvie syndrome is a serious condition that requires prompt recognition and management to prevent complications such as colonic perforation or ischemia. Understanding the clinical presentation, signs, symptoms, and patient characteristics is crucial for healthcare providers to identify at-risk patients and initiate appropriate treatment strategies. Early intervention, which may include medical management with neostigmine or decompressive procedures, can significantly improve patient outcomes[12][13].

Related Information

Approximate Synonyms

  • Acute Colonic Pseudo-Obstruction
  • Ogilvie's Syndrome
  • Colonic Pseudo-Obstruction
  • Non-Mechanical Colonic Obstruction
  • Functional Colonic Obstruction

Diagnostic Criteria

  • Abdominal distension and pain
  • Nausea and vomiting
  • Constipation symptoms
  • Absence of bowel sounds
  • No air-fluid levels on X-ray
  • Colonic dilation without obstruction on CT scan
  • Exclusion of mechanical obstruction
  • Ruling out other causes of colonic distension

Treatment Guidelines

  • Assess symptoms and medical history
  • Perform imaging studies to confirm dilation
  • Monitor electrolyte imbalances and renal function
  • Administer bowel rest and fluid management
  • Use prokinetic agents like metoclopramide or erythromycin
  • Consider neostigmine for enhanced colonic motility
  • Perform colonoscopy for diagnostic and therapeutic purposes
  • Reserve surgery for severe cases with risk of complications

Description

  • Dilation of the colon without obstruction
  • Impaired colonic motility leads to distension
  • No physical blockage present
  • Massive colonic distension results in impaired function
  • Caused by postoperative states or neurological conditions
  • Metabolic disturbances and medications can contribute
  • Abdominal distension, discomfort, nausea, vomiting common symptoms

Clinical Information

  • Abdominal distension common
  • Abdominal pain diffuse and severe
  • Nausea and vomiting frequent
  • Constipation due to impaired motility
  • Diminished bowel sounds observed
  • Signs of dehydration in severe cases
  • Affects older adults over 60 years
  • Comorbidities increase risk significantly
  • Certain medications impair motility

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