• A&A practice · Jan 2019

    Case Reports

    Methylnaltrexone-Associated Bowel Perforation in Postoperative Opioid-Induced Constipation and Ogilvie Syndrome: A Case Report.

    • Kevin A Blackney, Nirav V Kamdar, Chang Amber Liu, and David A Edwards.
    • From the Kaiser Permanente of Northern California, Oakland, California.
    • A A Pract. 2019 Jan 15; 12 (2): 44-46.

    AbstractPain management with opioids is often limited by medication side effects. One of the most common and distressing side effects is opioid-induced constipation (OIC), a syndrome that is now getting significant national attention. We report the case of an opioid-dependent 56-year-old man who underwent lumbar decompression for spinal stenosis. Postoperatively, he developed OIC and Ogilvie syndrome, then following treatment with methylnaltrexone experienced an acute bowel perforation. We briefly review the recommended management of OIC as well as indications and contraindications of methylnaltrexone and similar new medications.

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