Ogilvie's syndrome. Would you recognize it? Numerous conditions predispose to Ogilvie's syndrome, a process that mimics bowel obstruction. Characteristic radiographic findings of acute pseudo-obstruction include dilatation of the cecum and the remainder of the colon but not the small intestine. Treatment is individualized. Massive cecal dilatation carries the risk of cecal perforation and its attendant high mortality rate. Conservative therapies, such as nasogastric suction, gentle enemas, and use of a rectal tube, may be beneficial. Decompression by colonoscopy or other means may be necessary. 