Surgical treatment is the initial step in treating Ogilvie syndrome with a significantly dilated cecum

Acute colonic pseudo-blockage, also known as Ogilvie syndrome, is characterized by a significant dilatation of the colon due to a loss of function, without the presence of a mechanical obstruction that would impede the transit of intestinal contents. Treatment and diagnosis are challenging. It frequently occurs in patients receiving various pharmacological treatments, hospitalized or living in a nursing home, suffering from a persistent critical illness, or having insufficient mobilization during the postoperative phase. Neostigmine is commonly used in medical treatment for this reason. Conservative treatment is tried for up to three days if the diameter of the cecum is less than 12 cm and there is no perforation-producing peritonitis. It has also been suggested that pyridostigmine and prucalopride therapies are useful. An expert endoscopist can conduct colonoscopic decompression on individuals who do not respond to medicinal treatment. Daily application of polyethylene glycol following treatment lowers the risk of recurrence, if resolution is possible. In contrast, surgical intervention is necessary in cases of colonic ischemia, perforation, or peritonitis. The results of the exploratory process are used to determine the stoma opening and resection width. This article describes a patient whose cecum measured sixteen centimeters, who underwent ileorectal anastomosis following subtotal colectomy, did not respond to decompression, and did not benefit from four days of medical care.