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'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''


{{SI}}
{{Toxic megacolon}}
{{CMG}}
{{CMG}}; {{AE}} {{F.K}}


{{SK}} Megacolon toxicum
{{SK}} Megacolon toxicum; Toxic colitis


==Overview==
==[[Toxic megacolon overview|Overview]]==
'''Toxic megacolon''' 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]].
==[[Toxic megacolon historical perspective|Historical Perspective]]==


==Prognosis==
==[[Toxic megacolon pathophysiology|Pathophysiology]]==
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==
==[[Toxic megacolon causes|Causes]]==
*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.
==[[Toxic megacolon differential diagnosis|Differentiating Toxic Megacolon from other Diseases]]==


==Symptoms==
==[[Toxic megacolon epidemiology and demographics|Epidemiology and Demographics]]==
*[[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]].
==[[Toxic megacolon risk factors|Risk Factors]]==
 
==[[Toxic megacolon natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
 
==Diagnosis==
[[Toxic megacolon history and symptoms|History and Symptoms]] | [[Toxic megacolon physical examination|Physical Examination]] | [[Toxic megacolon laboratory findings|Laboratory Findings]] | [[Toxic megacolon abdominal x ray|Abdominal X Ray]] | [[Toxic megacolon CT|CT]] | [[Toxic megacolon MRI|MRI]] | [[Toxic megacolon other imaging findings|Other Imaging Findings]] | [[Toxic megacolon other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==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).
[[Toxic megacolon medical therapy|Medical Therapy]] | [[Toxic megacolon surgery|Surgery]] | [[Toxic megacolon primary prevention|Primary Prevention]] | [[Toxic megacolon secondary prevention|Secondary Prevention]] | [[Toxic megacolon cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Toxic megacolon future or investigational therapies|Future or Investigational Therapies]]


== External links ==
== Case Studies ==
*[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.
[[Toxic megacolon case study one|Case #1]]


{{Gastroenterology}}
{{Gastroenterology}}
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[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Disease]]
[[fr:mégacôlon toxique]]
[[fr:mégacôlon toxique]]
[[pl:Ostre rozdęcie okrężnicy]]
[[pl:Ostre rozdęcie okrężnicy]]

Latest revision as of 16:06, 29 November 2017

For patient information click here

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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]

Synonyms and keywords: Megacolon toxicum; Toxic colitis

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Toxic Megacolon from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Abdominal X Ray | CT | MRI | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

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