Percutaneous cecostomy for Ogilvie syndrome: laboratory observations and clinical experience.

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Abstract
Percutaneous cecostomy (PCC) was evaluate 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 be accomplished with a variety of techniques (eg, Seldinger or trocar puncture, tacking) and instruments (various types and sizes of retention and non retention catheters). Anatomic studies revealed that the cecum is surrounded by the peritoneum for as much as 270.degree. of its circumference, so that a retroperitoneal approach to PCC would probably be unfeasible in most patients. PCC 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 improtant option in the treatment of Ogilvie syndrome and that the procedure may obviate surgery and be lifesaving in certain high-risk patients.