Toxic megacolon surgery: Difference between revisions
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==Surgery== | ==Surgery== | ||
*1.Total or subtotal colectomy and ileostomy with | |||
**1.1.Hartmann pouch | |||
**1.2.Mucous fistula | |||
**1.3.Subcutaneous exteriorization of closed distal bowel | |||
*2.Total proctocolectomy and ileostomy | |||
*3.Diversion procedures | |||
**3.1.Ileostomy | |||
**3.2.Cecostomy | |||
**3.3.Ileostomy with transverse decompressive colostomy (Turnbull “blowhole” procedure) | |||
*4.Restorative procedures | |||
**4.1.Total colectomy and ileorectal anastomosis | |||
**4.2.Restorative proctocolectomy with ileal pouch–anal anastomosis | |||
==References== | ==References== |
Revision as of 18:46, 8 November 2017
Toxic Megacolon Microchapters |
Diagnosis |
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Treatment |
Case Studies |
Toxic megacolon surgery On the Web |
American Roentgen Ray Society Images of Toxic megacolon surgery |
Risk calculators and risk factors for Toxic megacolon surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Surgical intervention is not recommended for the management of [disease name].
OR
Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
OR
The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
OR
The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
OR
Surgery is the mainstay of treatment for [disease or malignancy].
Indications
- The mainstay of treatment for toxic megacolon is medical therapy. Surgery is usually reserved for patients with:[1]
- Failed medical therapy
- Progressive toxicity or dilation
- Signs of perforation
Indications for surgery | |
---|---|
Absolute | Relative |
Pnemuoperitoneum | Inability to promptly control sepsis |
Diffuse peritonitis | Increasing megacolon |
Localized peritonitis with increasing abdominal pain and/or colonic distension >10 cm | Failure to improve within 24–48 h |
Uncontrolled sepsis | Increasing toxicity or other signs of clinical deterioration |
Major hemorrhage | Continued transfusion requirements |
Surgery
- 1.Total or subtotal colectomy and ileostomy with
- 1.1.Hartmann pouch
- 1.2.Mucous fistula
- 1.3.Subcutaneous exteriorization of closed distal bowel
- 2.Total proctocolectomy and ileostomy
- 3.Diversion procedures
- 3.1.Ileostomy
- 3.2.Cecostomy
- 3.3.Ileostomy with transverse decompressive colostomy (Turnbull “blowhole” procedure)
- 4.Restorative procedures
- 4.1.Total colectomy and ileorectal anastomosis
- 4.2.Restorative proctocolectomy with ileal pouch–anal anastomosis
References
- ↑ Fischer, Josef (2007). Mastery of surgery. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9780781771658.