Mechanical GI obstruction presents with nausea, regurgitation or vomiting, increased gastric residual volume (GRV), abdominal pain and the absence of flatus or bowel movements. This requires surgical referral and treatment.

Acute colonic pseudo-obstruction (Ogilvie’s syndrome) is a diagnosis of exclusion based on massive colonic distension (>9 cm) and absence of mechanical obstruction (Figure 1). Predisposing conditions include trauma, surgery, cardiac disease, infection, renal failure,