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Megacolon

Presentation

A previously unreported case of localized leukocytoclastic vasculitis of the left colon resulting in the impressive presentation of megacolon, without the presence of any precipitating factor or associated systemic disease is presented here, with an overview [ncbi.nlm.nih.gov]

Gastrointestinal

  • Decreased Bowel Sounds

    Your healthcare provider may listen to your bowel for decreased bowel sounds resulting from decreased movement. They’ll take your vital signs to check for fever, low blood pressure and fast heart rate, which are all signs of toxicity. [my.clevelandclinic.org]

    On physical exam, abdominal tenderness and decreased bowel sounds are usually present.[5][11] In a study that focused on patients with C. difficile infection and toxic megacolon, the three most commonly seen complaints were diarrhea, malaise, and abdominal [ncbi.nlm.nih.gov]

Cardiovascular

  • Weak Pulse

    pulse, cool or clammy skin, dilated eyes, confusion, and rapid or shallow breathing [hopkinsmedicine.org]

Neurologic

  • Motor Disturbances

    Clinical Features and Colonic Motor Disturbances in Chronic Megacolon in Adults. Dig Dis Sci. 2015; 60 (8): p.2398-2407. doi: 10.1007/s10620-015-3645-5. | Open in Read by QxMD Camilleri M. [amboss.com]

Workup

(See also Etiology, Presentation, and Workup.) Toxic Megacolon. A 72-year-old woman presented with vomiting and abdominal distention. [emedicine.medscape.com]

Treatment

Most cases respond to medical treatment. Advanced cases of megacolon and megarectum can be treated surgically by Duhamel technique. [jcol.elsevier.es]

Toxic megacolon is a life-threatening condition that needs immediate treatment. [hopkinsmedicine.org]

This is a life-threatening complication that requires immediate medical treatment. The inflammation of Crohn disease is nearly always found in the ileocecal region. [mountsinai.org]

The treatment of the underlying cause, correction of any electrolyte disturbances (ex. hypokalemia), symptom management, and prevention of further complications are also important components of a good treatment plan.[15] Medical Management Initial treatment [ncbi.nlm.nih.gov]

Prognosis

Abstract Intestinal microvillous disorders are an uncommon cause of severe diarrhea, with very poor prognosis. [ncbi.nlm.nih.gov]

Treatment and prognosis Specific management depends on the underlying etiology and may involve a combination of supportive, pharmacological, and surgical management. References Promoted articles (advertising) [radiopaedia.org]

Outlook (Prognosis) If the condition does not improve, it can be fatal. Colon surgery is usually needed in such cases. [mountsinai.org]

Outlook / Prognosis Can you survive toxic megacolon? Your chances are good if you seek treatment soon enough. The overall survival rate for those treated for toxic megacolon is around 93%. [my.clevelandclinic.org]

Etiology

There are three etiological types of megacolon: acute, chronic, and toxic megacolon. [amboss.com]

Treatment and prognosis Specific management depends on the underlying etiology and may involve a combination of supportive, pharmacological, and surgical management. References Promoted articles (advertising) [radiopaedia.org]

The incidence rates can change based on the main etiology. [emedicine.medscape.com]

Mycobacterium avium subspecies paratuberculosis is a candidate etiological agent of Crohn's disease. Definitive causal connection between Mycobacterium avium subspecies paratuberculosis infection and Crohn's disease has not been demonstrated. [ncbi.nlm.nih.gov]

Epidemiology

CONCLUSIONS: The percentage of asymptomatic Chagas' patients who had a specific AAB pattern and had a beta1-AAB level above a defined cutoff point mirrors very well the epidemiological situation, which showed that clinical manifestations develop in nearly [ncbi.nlm.nih.gov]

Chagas megacolon. [3] Of the 34% of asymptomatic patients who demonstrated similar patterns of autoantibodies, 84% of these individuals also had levels of beta1 autoantibody that are typical for Chags cardiomyopathy, which the authors stated mirrored the epidemiologic [emedicine.medscape.com]

Epidemiology of congenital innervation defects of the distal colon. [jcol.elsevier.es]

Pathophysiology

Novel concepts in the diagnosis, pathophysiology and management of idiopathic megabowel. Colorectal Dis. 2008; 10 (6): p.531-538. doi: 10.1111/j.1463-1318.2007.01457.x. | Open in Read by QxMD Beattie GC, Peters RT, Guy S, Mendelson RM. [amboss.com]

Complications and management of fecal impaction and the pathophysiology of megacolon in the literature are reviewed and discussed. [ncbi.nlm.nih.gov]

The pathophysiology of chronic megacolon is incompletely understood. It likely represents an amalgam of primary disorders involving muscular and nervous systems of the intestine. Much basic science work has been performed in this area. [emedicine.medscape.com]

Prevention

Treating diseases that cause toxic megacolon, such as ulcerative colitis or Crohn disease, can prevent this condition. [mountsinai.org]

You may be given an IV of fluids and electrolytes to help nourish your body and prevent dehydration. Surgery. [hopkinsmedicine.org]

You may receive antibiotics to prevent sepsis (a severe infection). If the condition does not improve, it can be fatal. Colon surgery is usually needed in such cases. [medlineplus.gov]

Early management is key to preventing life-threatening complications, and it may prevent the need for surgery. If you do need an emergency colectomy and ostomy, know that you’ll have ample support to help you adjust to these changes going forward. [my.clevelandclinic.org]

CONCLUSION: A timely surgical intervention in recalcitrant fecal impactions may prevent possible stercoral ulcer perforation with a high mortality. [ncbi.nlm.nih.gov]

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