Toxic megacolon

Toxic megacolon is a life-threatening complication of other intestinal conditions. It is characterized by a very dilated colon(megacolon, accompanied by abdominal distention (bloating), and sometimes fever, abdominal pain, or shock.

Toxic megacolon is most usually a complicationof inflammatory bowel disease, such as ulcerative colitisand Crohn?s disease, and some other infectionsof the colon. Other forms of megacolon exist and can be congenital(present since birth, such as Hirschsprung's disease) or associated with some forms of constipation.

Symptoms

• Abdominal pain
• Abdominal bloating
• Abdominal tenderness
• Fever
• Tachycardia(rapid heart rate)
• Dehydration

There may be signs of septic shock. A physical examinationreveals abdominal tenderness and possible loss of bowel sounds. An abdominal radiographyshows colonic dilation. There is usually an elevated white blood cellcount. Blood electrolytesmay show a low potassium.

Treatment

The objective of treatment is to decompress the bowel and to prevent swallowed air from further distending the bowel. If decompression is not achieved or the patient does not improve within 24 hours, a colectomy(surgical removal of all or part of the colon) is indicated. Fluid and electrolyte replacement help to prevent dehydration and shock. Use of corticosteroidsmay be indicated to suppress the inflammatoryreaction in the colon if megacolon has resulted from active inflammatory bowel disease. Antibioticsmay be given to prevent sepsis(a severe infection).

Prognosis

If the condition does not improve, there is a significant risk of death. In case of poor response to conservative therapy a colectomy is usually required.

Complications

• Sepsis
• Shock
• Perforation of the colon

Emergency action may be required if severe abdominal pain develops -- particularly if it is accompanied by fever, rapid heart rate, tenderness when the abdomen is pressed, bloody diarrhea, frequent diarrhea, or painful bowel movements.

External links

Toxic megacolon. National Institutes of Health. Used as the public domain source for this article. Update on 1/26/2004 by: Sreeni Jonnalagadda, M.D., Interventional and Pancreatobiliary Endoscopy, Washington University School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network.

This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Toxic+megacolon Wikipedia article Toxic megacolon.