Ogilvie's syndrome is defined as a pseudo-obstruction of the colon of unknown cause. A review of recent literature shows a proliferation of reports of such cases associated to multiple conditions. The authors present two cases of perforated peptic ulcers with peritonitis that mimicked Ogilvie's syndrome in the clinical, radiological, and colonoscopic presentations. They propose that pseudo-obstruction cases obviously caused by adynamic ileus be excluded from the Ogilvie's syndrome classification, for a better understanding of its pathogenesis.108102-4