Colonic Pseudo-Obstruction in an Elderly Patient: Resolution Following Correction of Hypokalemia

Colonic pseudo-obstruction (Ogilvie's syndrome) is an uncommon but clinically significant cause of large bowel dilatation in the absence of mechanical obstruction. Electrolyte imbalances, particularly hypokalemia, can impair colonic motility and precipitate pseudo-obstruction. We report a case of an elderly male with multiple comorbidities who presented with progressive abdominal distention. Imaging revealed marked colonic dilation without a transition point, while laboratory testing showed severe hypokalemia (2.8 mmol/L). Conservative management, including electrolyte replacement, resulted in marked clinical improvement within 48 hours, following normalization of potassium to 4.0 mmol/L. This case underscores the importance of recognizing and correcting reversible metabolic disturbances before pursuing invasive interventions.