Toxic megacolon laboratory findings: Difference between revisions

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==Overview==
==Overview==
There is usually an elevated [[white blood cell]] count. Severe sepsis may present with hypothermia or [[leukopenia]].
Laboratory findings consistent with the diagnosis of toxic megacolon include [[anemia]] and [[leukocytosis]]. Some patients with toxic megacolon may have elevated [[Concentrations|concentration]] of  [[Erythrocyte sedimentation rate|Erythrocyte sedimentation rate (ESR)]] and [[C-reactive protein (CRP)]], which is usually suggestive of [[inflammation]].
 
==Laboratory Findings==
*Laboratory findings consistent with the diagnosis of toxic megacolon include:<ref name="pmid24163654">{{cite journal |vauthors=Antonopoulos P, Almyroudi M, Kolonia V, Kouris S, Troumpoukis N, Economou N |title=Toxic Megacolon and Acute Ischemia of the Colon due to Sigmoid Stenosis Related to Diverticulitis |journal=Case Rep Gastroenterol |volume=7 |issue=3 |pages=409–13 |year=2013 |pmid=24163654 |pmc=3806696 |doi=10.1159/000355345 |url=}}</ref><ref name="pmid12067">{{cite journal |vauthors=Caprilli R, Vernia P, Colaneri O, Torsoli A |title=Blood pH: a test for assessment of severity in proctocolitis |journal=Gut |volume=17 |issue=10 |pages=763–9 |year=1976 |pmid=12067 |pmc=1411181 |doi= |url=}}</ref><ref name="pmid9737284">{{cite journal |vauthors=Kuroki K, Masuda A, Uehara H, Kuroki A |title=A new treatment for toxic megacolon |journal=Lancet |volume=352 |issue=9130 |pages=782 |year=1998 |pmid=9737284 |doi= |url=}}</ref><ref name="Strong2010">{{cite journal|last1=Strong|first1=Scott|title=Management of Acute Colitis and Toxic Megacolon|journal=Clinics in Colon and Rectal Surgery|volume=23|issue=04|year=2010|pages=274–284|issn=1531-0043|doi=10.1055/s-0030-1268254}}</ref><ref name="pmid22009735">{{cite journal |vauthors=Autenrieth DM, Baumgart DC |title=Toxic megacolon |journal=Inflamm. Bowel Dis. |volume=18 |issue=3 |pages=584–91 |year=2012 |pmid=22009735 |doi=10.1002/ibd.21847 |url=}}</ref>
**[[Anemia]]
**[[Leukocytosis]] especially in patients with [[Clostridium difficile infection|''Clostridium difficile'' infection]]
**[[Hypoalbuminemia]]
**[[Metabolic alkalosis]] associated with a poor [[prognosis]]
**[[Metabolic acidosis]] secondary to [[ischemic colitis]]
*Some patients with toxic megacolon may have elevated [[Erythrocyte sedimentation rate|Erythrocyte sedimentation rate (ESR)]] and [[C-reactive protein (CRP)]] concentration.<ref name="BrownHaboubi2008">{{cite journal|last1=Brown|first1=S. R.|last2=Haboubi|first2=N.|last3=Hampton|first3=J.|last4=George|first4=B.|last5=Travis|first5=S. P. L.|title=The Management of Acute Severe Colitis: ACPGBI Position Statement|journal=Colorectal Disease|volume=10|year=2008|pages=8–29|issn=14628910|doi=10.1111/j.1463-1318.2008.01682.x}}</ref><ref name="pmid22131898">{{cite journal |vauthors=Strong SA |title=Management of acute colitis and toxic megacolon |journal=Clin Colon Rectal Surg |volume=23 |issue=4 |pages=274–84 |year=2010 |pmid=22131898 |pmc=3134807 |doi=10.1055/s-0030-1268254 |url=}}</ref><ref name="OrabonaValcamonico2015">{{cite journal|last1=Orabona|first1=Rossana|last2=Valcamonico|first2=Adriana|last3=Salemme|first3=Marianna|last4=Manenti|first4=Stefania|last5=Tiberio|first5=Guido AM|last6=Frusca|first6=Tiziana|title=Fulminant ulcerative colitis in a healthy pregnant woman|journal=World Journal of Gastroenterology|volume=21|issue=19|year=2015|pages=6060–6064|issn=1007-9327|doi=10.3748/wjg.v21.i19.6060}}</ref><ref name="pmid11144376">{{cite journal |vauthors=Chao HC, Chiu CH, Kong MS, Chang LY, Huang YC, Lin TY, Lou CC |title=Factors associated with intestinal perforation in children's non-typhi Salmonella toxic megacolon |journal=Pediatr. Infect. Dis. J. |volume=19 |issue=12 |pages=1158–62 |year=2000 |pmid=11144376 |doi= |url=}}</ref>
*[[Electrolyte disturbances]] are common secondary to [[inflammatory]] [[diarrhea]], [[steroid]] use and ongoing gastrointestinal losses.<ref name="Strong2010">{{cite journal|last1=Strong|first1=Scott|title=Management of Acute Colitis and Toxic Megacolon|journal=Clinics in Colon and Rectal Surgery|volume=23|issue=04|year=2010|pages=274–284|issn=1531-0043|doi=10.1055/s-0030-1268254}}</ref><ref name="pmid8282262">{{cite journal |vauthors=Panos MZ, Wood MJ, Asquith P |title=Toxic megacolon: the knee-elbow position relieves bowel distension |journal=Gut |volume=34 |issue=12 |pages=1726–7 |year=1993 |pmid=8282262 |pmc=1374472 |doi= |url=}}</ref><ref name="pmid9482465">{{cite journal |vauthors=Sheth SG, LaMont JT |title=Toxic megacolon |journal=Lancet |volume=351 |issue=9101 |pages=509–13 |year=1998 |pmid=9482465 |doi=10.1016/S0140-6736(97)10475-5 |url=}}</ref><ref><nowiki>{cite book | last = Koyfman | first = Alex | title = Emergency medicine images for practice : an overview of X-ray, ultrasound, CT, and MRI images | publisher = Wolters Kluwer | location = Philadelphia | year = 2016 | isbn = 9781451192209 }}</nowiki></ref>
 
==References==
==References==
{{reflist|2}}
{{Reflist|2}}
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Latest revision as of 15:42, 28 November 2017

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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

Laboratory findings consistent with the diagnosis of toxic megacolon include anemia and leukocytosis. Some patients with toxic megacolon may have elevated concentration of Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), which is usually suggestive of inflammation.

Laboratory Findings

References

  1. Antonopoulos P, Almyroudi M, Kolonia V, Kouris S, Troumpoukis N, Economou N (2013). "Toxic Megacolon and Acute Ischemia of the Colon due to Sigmoid Stenosis Related to Diverticulitis". Case Rep Gastroenterol. 7 (3): 409–13. doi:10.1159/000355345. PMC 3806696. PMID 24163654.
  2. Caprilli R, Vernia P, Colaneri O, Torsoli A (1976). "Blood pH: a test for assessment of severity in proctocolitis". Gut. 17 (10): 763–9. PMC 1411181. PMID 12067.
  3. Kuroki K, Masuda A, Uehara H, Kuroki A (1998). "A new treatment for toxic megacolon". Lancet. 352 (9130): 782. PMID 9737284.
  4. 4.0 4.1 Strong, Scott (2010). "Management of Acute Colitis and Toxic Megacolon". Clinics in Colon and Rectal Surgery. 23 (04): 274–284. doi:10.1055/s-0030-1268254. ISSN 1531-0043.
  5. Autenrieth DM, Baumgart DC (2012). "Toxic megacolon". Inflamm. Bowel Dis. 18 (3): 584–91. doi:10.1002/ibd.21847. PMID 22009735.
  6. Brown, S. R.; Haboubi, N.; Hampton, J.; George, B.; Travis, S. P. L. (2008). "The Management of Acute Severe Colitis: ACPGBI Position Statement". Colorectal Disease. 10: 8–29. doi:10.1111/j.1463-1318.2008.01682.x. ISSN 1462-8910.
  7. 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.
  8. Orabona, Rossana; Valcamonico, Adriana; Salemme, Marianna; Manenti, Stefania; Tiberio, Guido AM; Frusca, Tiziana (2015). "Fulminant ulcerative colitis in a healthy pregnant woman". World Journal of Gastroenterology. 21 (19): 6060–6064. doi:10.3748/wjg.v21.i19.6060. ISSN 1007-9327.
  9. Chao HC, Chiu CH, Kong MS, Chang LY, Huang YC, Lin TY, Lou CC (2000). "Factors associated with intestinal perforation in children's non-typhi Salmonella toxic megacolon". Pediatr. Infect. Dis. J. 19 (12): 1158–62. PMID 11144376.
  10. Panos MZ, Wood MJ, Asquith P (1993). "Toxic megacolon: the knee-elbow position relieves bowel distension". Gut. 34 (12): 1726–7. PMC 1374472. PMID 8282262.
  11. Sheth SG, LaMont JT (1998). "Toxic megacolon". Lancet. 351 (9101): 509–13. doi:10.1016/S0140-6736(97)10475-5. PMID 9482465.
  12. {cite book | last = Koyfman | first = Alex | title = Emergency medicine images for practice : an overview of X-ray, ultrasound, CT, and MRI images | publisher = Wolters Kluwer | location = Philadelphia | year = 2016 | isbn = 9781451192209 }}

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