Toxic megacolon physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]
Overview
Patients with toxic megacolon usually appear ill. Physical examination of patients with toxic megacolon is usually remarkable for abdominal pain, rebound tenderness and guarding, hypotension and tachycardia.
Physical Examination
Patients with toxic megacolon usually appear ill and dehydrated. Physical examination of patients with toxic megacolon is usually remarkable for abdominal pain and tenderness, abdominal distention, decreased bowel sounds.[1][2][3][4][5]
Appearance of the Patient
- Patients with toxic megacolon usually appear ill.[6]
Vital Signs
- High-grade fever (usually temperature >101.5°F (38.6°C)
- Tachycardia with regular pulse ( usually heart rate >120 beats/min)
- Low blood pressure with normal pulse pressure
Skin
Abdomen
Abdominal examination may reveal signs of peritoneal irritation including:[2][6]
- Abdominal distention
- Abdominal rebound tenderness
- Abdominal guarding
- Abdominal rigidity
Neuromuscular
References
- ↑ Gan, S. Ian; Beck, P. L. (2003). "A new look at toxic megacolon: an update and review of incidence, etiology, pathogenesis, and management". The American Journal of Gastroenterology. 98 (11): 2363–2371. doi:10.1111/j.1572-0241.2003.07696.x. ISSN 0002-9270.
- ↑ 2.0 2.1 Jalan KN, Sircus W, Card WI, Falconer CW, Bruce CB, Crean GP, McManus JP, Small WP, Smith AN (1969). "An experience of ulcerative colitis. I. Toxic dilation in 55 cases". Gastroenterology. 57 (1): 68–82. PMID 5305933.
- ↑ Strong SA (2010). "Management of acute colitis and toxic megacolon". Clin Colon Rectal Surg. 23 (4): 274–84. doi:10.1055/s-0030-1268254. PMC 3134807. PMID 22131898.
- ↑ Sayedy, Leena (2010). "Toxic megacolon associatedClostridium difficilecolitis". World Journal of Gastrointestinal Endoscopy. 2 (8): 293. doi:10.4253/wjge.v2.i8.293. ISSN 1948-5190.
- ↑ Hefaiedh R, Cheikh M, Ennaifer R, Gharbi L, Hadj NB (2013). "Toxic megacolon complicating a first course of Crohn's disease: about two cases". Clin Pract. 3 (2): e24. doi:10.4081/cp.2013.e24. PMC 3981266. PMID 24765512.
- ↑ 6.0 6.1 SILVERBERG D, ROGERS AG (1964). "TOXIC MEGACOLON IN ULCERATIVE COLITIS". Can Med Assoc J. 90: 357–63. PMC 1922240. PMID 14122466.