Korean J Gastroenterol.  2021 Jun;77(6):313-316. 10.4166/kjg.2021.034.

Acute Colonic Pseudo-obstruction Induced by Neuroleptic Malignant Syndrome

Affiliations
  • 1Division of Gastroenterology, Department of Internal Medicine, Dong-A University Hospital, Busan, Korea

Abstract

A colonic pseudo-obstruction is a disorder that causes abdominal distension and abdominal pain similar to a mechanical obstruction, but there are no structural lesions that can obstruct the gastrointestinal tract. This condition can be acute or chronic. An acute colonic pseudo-obstruction, also called Ogilvie's syndrome, is believed to be a condition induced by other causes that are different from a chronic colonic pseudo-obstruction. The pathogenesis involves abnormalities in the autonomic nervous system induced by systemic diseases or medications, and it often improves when the primary causes are treated. On the other hand, a chronic colonic pseudo-obstruction can occur repeatedly without a particular cause. The authors encountered neuroleptic malignant syndrome that caused acute colonic pseudo-obstruction. This paper reports a case with a review of the relevant literature. This is the first case reported in Korea. This case shows that physicians should consider neuroleptic malignant syndrome as a cause of an acute colonic pseudo-obstruction.

Keyword

Colonic pseudo-obstruction; Neuroleptic malignant syndrome; Schizophrenia

Figure

  • Fig. 1 (A) Computed tomography and (B) abdominal X-ray showing the pseudo-obstruction.

  • Fig. 2 (A) Abdominal X-ray without improvement on the 3rd day of hospitalization, (B) abdominal X-ray showing improvement on the 5th day of hospitalization.

  • Fig. 3 Sequential changes in the laboratory data, including creatinine and creatine phosphokinase.


Reference

1. Di Lorenzo C. 1999; Pseudo-obstruction: current approaches. Gastroenterology. 116:980–987. DOI: 10.1016/S0016-5085(99)70082-X. PMID: 10092321.
Article
2. Stanghellini V, Cogliandro RF, de Giorgio R, Barbara G, Salvioli B, Corinaldesi R. 2007; Chronic intestinal pseudo-obstruction: manifestations, natural history and management. Neurogastroenterol Motil. 19:440–452. DOI: 10.1111/j.1365-2982.2007.00902.x. PMID: 17564625.
Article
3. Vanek VW, Al-Salti M. 1986; Acute pseudo-obstruction of the colon (Ogilvie's syndrome). An analysis of 400 cases. Dis Colon Rectum. 29:203–210. DOI: 10.1007/BF02555027. PMID: 3753674.
4. Delmer A, Cymbalista F, Bauduer F, et al. 1995; Acute colonic pseudo-obstruction (Ogilvie's syndrome) during induction treatment with chemotherapy and all-trans-retinoic acid for acute promyelocytic leukemia. Am J Hematol. 49:97–98. DOI: 10.1002/ajh.2830490120. PMID: 7741149.
Article
5. Xie H, Peereboom DM. 2012; Ogilvie's syndrome during chemotherapy with high-dose methotrexate for primary CNS lymphoma. J Clin Oncol. 30:e192–e194. DOI: 10.1200/JCO.2011.40.6801. PMID: 22711852.
Article
6. Johnston G, Vitikainen K, Knight R, Annest L, Garcia C. 1992; Changing perspective on gastrointestinal complications in patients undergoing cardiac surgery. Am J Surg. 163:525–529. DOI: 10.1016/0002-9610(92)90402-D. PMID: 1575312.
Article
7. Sreter KB, Barisic B, Popovic-Grle S. 2017; Pharmacogenomics and tailored polypharmacy: an 80-year-old lady with rosuvastatin-associated rhabdomyolysis and maprotiline-related Ogilvie's syndrome. Int J Clin Pharmacol Ther. 55:442–448. DOI: 10.5414/CP202784. PMID: 28257284.
Article
8. De Giorgio R, Barbara G, Stanghellini V, et al. 2001; Review article: the pharmacological treatment of acute colonic pseudo-obstruction. Aliment Pharmacol Ther. 15:1717–1727. DOI: 10.1046/j.1365-2036.2001.01088.x. PMID: 11683685.
9. Ogilvie H. 1948; Large-intestine colic due to sympathetic deprivation; a new clinical syndrome. Br Med J. 2:671–673. DOI: 10.1136/bmj.2.4579.671. PMID: 18886657. PMCID: PMC2091708.
10. Levenson JL. 1985; Neuroleptic malignant syndrome. Am J Psychiatry. 142:1137–1145. DOI: 10.1176/ajp.142.10.1137. PMID: 2863986.
11. Stübner S, Rustenbeck E, Grohmann R, et al. 2004; Severe and uncommon involuntary movement disorders due to psychotropic drugs. Pharmacopsychiatry. 37 Suppl 1:S54–S64. DOI: 10.1055/s-2004-815511. PMID: 15052515.
Article
12. Shalev A, Hermesh H, Munitz H. 1989; Mortality from neuroleptic malignant syndrome. J Clin Psychiatry. 50:18–25. DOI: 10.1016/0006-3223(89)90275-8. PMID: 2562951.
13. Nielsen J, Meyer JM. 2012; Risk factors for ileus in patients with schizophrenia. Schizophr Bull. 38:592–598. DOI: 10.1093/schbul/sbq137. PMID: 21112965. PMCID: PMC3329981.
Article
14. de Bruin GJ, Bac DJ, van Puijenbroek EP, van der Klooster JM. 2009; Ogilvie syndrome induced by clozapine. Ned Tijdschr Geneeskd. 153:B437. PMID: 20051163.
15. Pelizza L, De Luca P, La Pesa M, Borella D. 2007; Clozapine-induced intestinal occlusion: a serious side effect. Acta Biomed. 78:144–148. PMID: 17933283.
16. Lo TC, Unwin MR, Dymock IW. 1989; Neuroleptic malignant syndrome: another medical cause of acute abdomen. Postgrad Med J. 65:653–655. DOI: 10.1136/pgmj.65.767.653. PMID: 2608597. PMCID: PMC2429179.
Article
17. Dudley HA, Paterson-Brown S. 1986; Pseudo-obstruction. Br Med J (Clin Res Ed). 292:1157–1158. DOI: 10.1136/bmj.292.6529.1157. PMID: 3085764. PMCID: PMC1340174.
Article
18. Gurrera RJ, Caroff SN, Cohen A, et al. 2011; An international consensus study of neuroleptic malignant syndrome diagnostic criteria using the Delphi method. J Clin Psychiatry. 72:1222–1228. DOI: 10.4088/JCP.10m06438. PMID: 21733489.
Article
19. Caroff SN, Mann SC. 1993; Neuroleptic malignant syndrome. Med Clin North Am. 71:185–202. DOI: 10.1016/S0025-7125(16)30278-4. PMID: 8093494.
Article
Full Text Links
  • KJG
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr