Ogilvie's syndrome in a patient with multiple myeloma.

Ogilvie's syndrome is characterized by physical examination and radiologic findings indicative of mechanical obstruction but in which no physical obstructive process can be found. Many factors have been associated with this syndrome which include electrolyte imbalance, systemic infection, drugs, and occasionally, neurologic disease. A case of acute colonic pseudoobstruction is presented which developed in a patient with multiple myeloma. The patient presented with severe thoracic pain, persistent and increasing abdominal distention and lack of bowel sounds. Plain radiography and ultrasonography revealed massive dilatation of the right and transverse colon. Nasogastric aspiration was initiated and all analgesic drugs were withdrawn. Erythromycin was given for nine days as prokinetic and a rectal tube was inserted for one day. Abdominal distention gradually disappeared within one day of nasogastric and rectal tube insertion and with multiple myeloma management. Ogilvie's syndrome is a very rare complication of multiple myeloma. Only one case of Ogilvie's syndrome with multiple myeloma has been reported in the literature. This case report of Ogilvie's syndrome in a patient with multiple myeloma is the second case report in the literature.