Acute Colonic Pseudo-Obstruction After Ventriculoperitoneal Shunt Placement for Normal Pressure Hydrocephalus

Ogilvie's syndrome is a rare postoperative condition commonly referred to as a "colonic pseudo-obstruction" due to the absence of mechanical obstruction. It should be a differential for patients over the age of 60 years who present with nausea, vomiting, and colonic dilatations on imaging. Ogilvie's syndrome following a ventriculoperitoneal (VP) shunt placement is an extremely rare entity with only one other adult patient reported in the English literature. In this case report, we explore the diagnosis and management of a 76-year-old patient who presented with abdominal pain and multiple bouts of bilious, non-bloody vomitus two days after a ventriculoperitoneal shunt. The ultimate diagnosis of Ogilvie's syndrome along with imaging and subsequent management is detailed, and diagnosis guidelines and treatment options for Ogilvie's syndrome are analyzed and explained. This case highlights the importance of keeping Ogilvie's syndrome on the list of differentials in a postoperative patient in all abdominal surgeries, even if they are minimally invasive.