Acute colonic pseudoobstruction.

Acute colonic pseudoobstruction (ACPO), often referred to as Ogilvie syndrome, is a clinical entity characterized by severe colonic distension (adult acute megacolon) in the absence of mechanical obstruction. It can result in abdominal ischemia and perforation if left untreated. This article discusses the epidemiology and current pathophysiologic theories of ACPO as well as the clinical presentation and diagnostic modalities utilized to identify the disease. In addition, this article describes the current treatment options for ACPO, which range from conservative medical therapy, therapeutic endoscopy, to subtotal colectomy.

Magnetic resonance enterography: the test of choice in diagnosing intestinal "zebras".

Small bowel tumors and other rare intestinal disorders are often exceedingly difficult to identify. Even cutting-edge technologies, such as push enteroscopy and capsule endoscopy, can fail to determine the cause of a patient's symptoms. At our institution magnetic resonance enterography (MRE) has become an increasingly reliable tool in the difficult-to-diagnose or difficult-to-monitor patient. In this retrospective case series, we discuss four patients with four rare intestinal disorders that were successfully diagnosed using MRE after failing to be diagnosed using more routine technologies, such as CT scans and flexible sigmoidoscopies. With the discussion of these four cases we demonstrate that MRE is a useful diagnostic modality in patients whose surveillance is difficult or to diagnose rare colorectal disease phenomena, colloquially referred to as "zebras."