Association Between Acute Colonic Pseudo-Obstruction (Ogilvie Syndrome) And Nimodipine Use. Case Series And Comprehensive Review

Abstract Background:Nimodipine is a calcium channel blocker indicated for the management of patients with aneurysmal subarachnoid hemorrhage (SAH). Oral nimodipine has rarely been implicated in the development of acute colonic pseudo-obstruction in patients treated for SAH. Nimodipine acts by inhibiting the transmembrane influx of calcium ions essential for the excitation-contraction coupling process of smooth muscle cells. We thought that its mechanism of action could predispose patients to develop acute colonic pseudo-obstruction (Ogilvie syndrome). The purpose of this study was to revise the existing literature concerning the association between acute colonic pseudo-obstruction and nimodipine use in patients with SAH. Methods: Two patients with aneurysmal SAH who received oral nimodipine and developed Ogilvie syndrome were discussed. All previously published cases of aneurysmal SAH associated with acute colonic pseudo-obstruction were reviewed. Conclusion: This report linking the oral use of nimodipine with Ogilvie syndrome may further support the association of this disease with nimodipine use during the treatment of patients with aneurysmal SAH.