Pediatric Ogilvie Syndrome Following Laparoscopic Appendectomy: A Case Report and Literature Review.

Acute colonic pseudo-obstruction (ACPO), or Ogilvie syndrome, is a rare cause of massive colonic dilation in children, occurring without mechanical obstruction. Its subtle presentation often mimics ileus or bowel obstruction, which may delay diagnosis and increase the risk of ischemia or perforation. We report the case of a seven-year-old boy who developed ACPO two weeks after a laparoscopic appendectomy for perforated appendicitis. Imaging revealed significant colonic distention without a transition point. The patient improved with supportive care, including bowel rest, intravenous fluids, and serial imaging, avoiding pharmacologic or surgical intervention. This case underscores the importance of maintaining a high index of suspicion for ACPO in postoperative pediatric patients with abdominal distention. Timely diagnosis and a stepwise management approach are essential to prevent complications and reduce the need for invasive treatment. A brief review of the literature is included to highlight current diagnostic and therapeutic strategies in pediatric ACPO.