Toxic megacolon
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2007-10-26T08:04:10Z
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Reverted edits by [[Special:Contributions/71.228.91.197|71.228.91.197]] ([[User talk:71.228.91.197|talk]]) to last version by ClueBot
{{Infobox_Disease |
Name = {{PAGENAME}} |
Image = |
Caption = |
DiseasesDB = 27702 |
ICD10 = {{ICD10|K|59|3|k|55}} |
ICD9 = {{ICD9|564.7}} |
ICDO = |
OMIM = |
MedlinePlus = |
eMedicineSubj = med |
eMedicineTopic = 1418 |
eMedicine_mult = {{eMedicine2|radio|702}} |
MeshID = D008532 |
}}
'''Toxic megacolon''' (''megacolon toxicum'') is a life-threatening complication of other intestinal conditions. It is characterized by a very dilated [[Colon (anatomy)|colon]] ([[megacolon]]), accompanied by abdominal distension ([[bloating]]), and sometimes [[fever]], [[abdominal pain]], or [[Shock (medical)|shock]].
Toxic megacolon is most usually a [[Complication (medicine)|complication]] of [[inflammatory bowel disease]], such as [[ulcerative colitis]] and, more rarely, [[Crohn’s disease]], and some [[infections]] of 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]]
*[[Bloating|Abdominal bloating]]
*Abdominal tenderness
*[[Fever]]
*[[Tachycardia]] (rapid heart rate)
*[[Dehydration]]
There may be signs of [[septic shock]]. A [[physical examination]] reveals abdominal tenderness and possible loss of bowel sounds. An abdominal [[radiography]] shows colonic dilation. There is usually an elevated [[white blood cell]] count. Severe sepsis may present with hypothermia or [[leukopenia]].
==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 [[corticosteroid]]s may be indicated to suppress the [[inflammatory]] reaction in the colon if megacolon has resulted from active inflammatory bowel disease. [[Antibiotics]] may 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 ==
*[http://www.nlm.nih.gov/medlineplus/ency/article/000248.htm 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.
{{Gastroenterology}}
[[Category:Surgery]]
[[Category:Gastroenterology]]
[[fr:mégacôlon toxique]]
[[pl:Ostre rozdęcie okrężnicy]]