Subject(s)
Humans , Colitis , Hemorrhage , Inflammatory Bowel Diseases , Megacolon, Toxic/surgery , Megacolon, Toxic/diagnosis , Megacolon, Toxic/etiology , Megacolon, Toxic/drug therapy , Megacolon, Toxic/therapy , Intestinal Perforation/surgery , Intestinal Perforation/diagnosis , Intestinal Perforation/epidemiology , Intestinal Perforation/mortality , Anti-Bacterial Agents/therapeutic use , Colectomy , Enterocolitis, Pseudomembranous , Proctocolectomy, RestorativeABSTRACT
El megacolon tóxico o dilatación aguda tóxica del colon es la complicación más grave de la colitis ulcerosa,afección en la que se presenta entre el 1 y 3 por ciento de los casos y alcanza una mortalidad de 12 a 30 por ciento. Son factores desencadenantes los trastornos electrolíticos (hipokalemia); los opíaceos; los antidiarreicos y los anticolinérgicos; los lavados intestinales y las exploraciones endoluminares (endoscopias). El tratamiento debe realizarse en una Unidad de Cuidados Intensivos y consiste en hidratación parenteral; reposiciones de electrólitos; transfusión de glóbulos rojos; antibióticos; corticoesteroides y descompresión (sonda nasoyeyunal). El 20 por ciento de los pacientes llegan a la cirugía de urgencia, cuya mortalidad fluctúa entre 10 y 15 por ciento
Subject(s)
Humans , Colitis, Ulcerative/complications , Megacolon, Toxic/diagnosis , Anti-Bacterial Agents/therapeutic use , Decompression , Erythrocyte Transfusion , Hydrocortisone/therapeutic use , Megacolon, Toxic/etiology , Megacolon, Toxic/therapy , Metronidazole/therapeutic use , Parenteral Nutrition , Precipitating FactorsABSTRACT
We report a 67 years old male that consulted due to bloody diarrhea of several months of evolution and emaciation. According to endoscopic and radiological findings, the diagnosis of severe ulcerative colitis was made. Fifteen days after admission, the patient was subjected to an emergency total colectomy due to a toxic megacolon. The pathological study showed an eschemic colitis with extensive longitudinal ulcers in the antimesenteric border, presence of granulation tissue with inflammation and transmural fibrosis. Intestinal transit was reconstituted 6 months later and after 12 months of follow up, the patient is in good conditions
Subject(s)
Humans , Male , Aged , Colitis, Ischemic/complications , Megacolon, Toxic/etiology , Colitis, Ischemic/diagnosis , Colitis, Ischemic/therapy , Diagnosis, Differential , Megacolon, Toxic/diagnosis , Megacolon, Toxic/therapyABSTRACT
A new case of Shigella-caused megacolon is described in detailed form. Some considerations are made about frequency, pathology, clinic and prognostic features