Typically present in patients with concomitant acute comorbid conditions
Commonly: significant spinal or retroperitoneal trauma
Also: significant electrolyte imbalances, significant opioid exposure
Presenting signs and symptoms are the same as [[large bowel obstruction:
Abdominal pain/distension
Obstipation
In contrast to mechanical obstruction, 40-50% will continue to pass flatus
Vomiting
Commonly: significant spinal or retroperitoneal trauma
Also: significant electrolyte imbalances, significant opioid exposure
Abdominal pain/distension
Obstipation
In contrast to mechanical obstruction, 40-50% will continue to pass flatus
Vomiting
In contrast to mechanical obstruction, 40-50% will continue to pass flatus
Dilated bowel may be palpable
Findings suggestive of dehydration, sepsis, and gangrene/perforation may be present, depending on the extent of progression
Peritoneal signs and fever suggest perforation
Ogilvie's syndrome
Malignancy 
Dressler's syndrome
Diverticular disease
Fitz-Hugh-Curtis syndrome
Compression from metastatic disease
Mallory-Weiss tear
Impaction