Aidan at 10:53, 2 August 2020

2020-08-02T10:53:38Z

← Older revision		Revision as of 10:53, 2 August 2020
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	== ~~Definition~~ ==		==Background==

	* Acute colonic distension that can lead to perforation and death		*Acute colonic distension that can lead to perforation and death

	== Etiology ==		===Etiology===

	* Inflammatory bowel disease		*[[Inflammatory bowel disease]]
	** Ulcerative colitis is most common		**[[Ulcerative colitis]] is most common
	** Crohn's disease, rarely		**[[Crohn disease]], rarely
	* Gastrointestinal infection		*Gastrointestinal infection
	** ''~~Clostridium~~ difficile''		**''[[Clostridioides difficile]]''
	** ''Entamoeba histolytica''		**''[[Entamoeba histolytica]]''
	** Shigella		**''[[Shigella]]''
	* Congenital		*Congenital
	** Hirschsprung's disease		**[[Hirschsprung disease]]

	== Clinical ~~Presentation~~ ==		==Clinical Manifestations==

	* Abdominal pain		*Abdominal pain
	* Signs of sepsis		*Signs of sepsis
	** Fever		**Fever
	** Hypotension		**Hypotension
	** Shock		**Shock
	* Signs of IBD (usually ulcerative colitis)		*Signs of IBD (usually ulcerative colitis)
	* May be first presentation of IBD		*May be first presentation of IBD

	== Investigations ==		==Investigations==

	* Imaging:		*Imaging:
	** Abdominal X-ray will show colon dilated > 6cm		**Abdominal X-ray will show colon dilated > 6cm

	== Diagnosis ==		==Diagnosis==

	* Radiographic evidence of colonic distension		*Radiographic evidence of colonic distension
	* Plus at least three of:		*Plus at least three of:
	** Fever > 38ºC		**Fever > 38ºC
	** Heart rate > 120bpm		**Heart rate > 120bpm
	** WBC > 10.5		**WBC > 10.5
	** Anemia		**Anemia
	* Plus at least one of:		*Plus at least one of:
	** Volume depletion		**Volume depletion
	** Altered sensorium		**Altered sensorium
	** Electrolyte abnormalities		**Electrolyte abnormalities
	** Hypotension		**Hypotension

	== Management ==		==Management==

	* Conservative		*Conservative
	** Bowel rest, NG tube		**Bowel rest, NG tube
	** If IBD: steroids		**If IBD: steroids
	** If infectious: antibiotics		**If infectious: antibiotics
	* If conservative treatment fails, proceed to surgery for subtotal colectomy and end-ileostomy		*If conservative treatment fails, proceed to surgery for subtotal colectomy and end-ileostomy

	[[Category:Gastroenterology]]		[[Category:Gastroenterology]]

Maintenance script: Imported from text file

2020-07-04T01:17:59Z

Imported from text file

New page

== Definition ==

* Acute colonic distension that can lead to perforation and death

== Etiology ==

* Inflammatory bowel disease
** Ulcerative colitis is most common
** Crohn's disease, rarely
* Gastrointestinal infection
** ''Clostridium difficile''
** ''Entamoeba histolytica''
** Shigella
* Congenital
** Hirschsprung's disease

== Clinical Presentation ==

* Abdominal pain
* Signs of sepsis
** Fever
** Hypotension
** Shock
* Signs of IBD (usually ulcerative colitis)
* May be first presentation of IBD

== Investigations ==

* Imaging:
** Abdominal X-ray will show colon dilated > 6cm

== Diagnosis ==

* Radiographic evidence of colonic distension
* Plus at least three of:
** Fever > 38ºC
** Heart rate > 120bpm
** WBC > 10.5
** Anemia
* Plus at least one of:
** Volume depletion
** Altered sensorium
** Electrolyte abnormalities
** Hypotension

== Management ==

* Conservative
** Bowel rest, NG tube
** If IBD: steroids
** If infectious: antibiotics
* If conservative treatment fails, proceed to surgery for subtotal colectomy and end-ileostomy

[[Category:Gastroenterology]]

Toxic megacolon - Revision history

Aidan at 10:53, 2 August 2020

Maintenance script: Imported from text file