Radiology, Vol 175, 679-682, Copyright © 1990 by Radiological Society of North America
Percutaneous cecostomy for Ogilvie syndrome: laboratory observations and clinical experience
E vanSonnenberg, RR Varney, G Casola, S Macaulay, GR Wittich, AM Polansky and M Schechter
Department of Radiology, University of California San Diego Medical Center 92103.
Percutaneous cecostomy (PCC) was evaluated in dogs and cadavers and by
means of review of intraperitoneal contrast material-enhanced computed
tomographic (CT) scans and clinical experience in five patients with
Ogilvie syndrome. It was shown that PCC can be accomplished with a variety
of techniques (e.g. Seldinger or trocar puncture, tacking) and instruments
(various types and sizes of retention and nonretention catheters). Anatomic
studies revealed that the cecum is surrounded by the peritoneum for as much
as 270 degrees of its circumference, so that a retroperitoneal approach to
PCC would probably be unfeasible in most patients. PCC was effective in
treating all five patients in this study, despite their advanced age and
complicated medical conditions. Decompression of colonic gas was achieved
with 8-12-F catheters, and no major complications occurred. Endoscopic
decompression had been unsuccessfully attempted in four of the patients
previously. It is concluded that PCC may be an important option in the
treatment of Ogilvie syndrome and that the procedure may obviate surgery
and be lifesaving in certain high-risk patients.
