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Toxic megacolonDefinition Toxic megacolon is a life-threatening complication of other intestinal conditions. It is characterized by a very inflated colon, abdominal distention, and sometimes fever, abdominal pain, or shock. Causes, incidence, and risk factors This is a complication of inflammatory bowel disease, such as ulcerative colitis and Crohn’s disease, and some infections of the colon. Other forms of megacolon exist and can be congenital (present since birth) or associated with some forms of constipation. Symptoms
Signs and tests There may be signs of septic shock. The doctor will notice abdominal tenderness and possible loss of bowel sounds.
Treatment The objective of treatment is to reduce the size of the bowel and to prevent swallowed air from further distending the bowel. If this is not achieved or the patient does not improve within 24 hours, a colectomy (surgical removal of all or part of the colon) is indicated. Fluid and electrolyte replacement help to prevent dehydration and shock. Use of corticosteroids may suppress the inflammatory reaction in the colon if megacolon has resulted from active inflammatory bowel disease. Antibiotics may be given to prevent sepsis (a severe infection). Expectations (prognosis) If the condition does not improve, there is a significant risk of death. In this situation, acolectomy is usually required. Complications
Calling your health care provider Go to the emergency room or call the local emergency number (such as 911) if severe abdominal pain develops -- particularly if it is accompanied by fever, rapid heart rate, tenderness when the abdomen is pressed, bloody diarrhea, frequent diarrhea, or painful bowel movements. Prevention Treatment of the underlying disease is important in preventing toxic megacolon. Illustrations
Page Content: Toxic dilation of the colon; Megarectum |
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