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Colegio de Medicina Interna de México.

2012, Number 3

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Med Int Mex 2012; 28 (3)

Toxic megacolon

Carrillo-Esper R, Calderón-Álvarez TJL, Muciño-Bermejo J, Ramírez-Rosillo FJ

Language: Spanish
References: 21
Page: 282-287
PDF size: 373.58 Kb.


ABSTRACT

Toxic megacolon is a potentially fatal and uncommon disease which is described as colonic distension greater than 6 cm in diameter associated with acute colitis and systemic symptoms. Its incidence is higher among patients who suffer from inflammatory bowel disease, infections or ischemic insults. Due to its high morbidity and mortality, early diagnosis and treatment are fundamental. Pathogenic mechanisms involved in the genesis of toxic megacolon include elevated levels of nitric oxide and inflammatory mediators which are product of colonic damage. Recent studies have showed that small bowel and gastric distension, conjoined to colitis, is associated with higher morbidity and mortality. Factors that possibly exacerbate toxic megacolon presentation include the use of narcotics and anticholinergic drugs, therefore they must be withdrawn. It is of vital importance to follow-up patients with imaging studies to opportunely detect complications and also to evaluate the progress of the inflammatory process. Management involves antibiotic treatment, anti-inflammatory medications, support measures and surgery in the cases that require so. The aim of this paper is to report a case of toxic megacolon diagnosed and treated in our institution, we also present a review of current scientific literature related to this entity.


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