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

A&A Practice
Kevin A BlackneyDavid A Edwards

Abstract

Pain 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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Citations

Oct 15, 2021·The American Surgeon·Jennifer BeaversMichael C Smith
Feb 25, 2021·Journal of the American Association of Nurse Practitioners·Danielle G WeekesFotios P Tjoumakaris

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