1/56. A patient who survived total colonic type ulcerative colitis complicated by toxic megacolon, disseminated intravascular coagulation, methicillin-resistant staphylococcus aureus infection and bilateral femoral phlebothrombosis.We report a patient who survived total colonic type ulcerative colitis (UC) complicated by toxic megacolon (TM), disseminated intravascular coagulation (DIC), methicillin-resistant staphylococcus aureus infection, and phlebothrombosis. A 69-year-old man was treated for about 4 months under the diagnosis of ischemic colitis at another hospital, and was transferred to our hospital. Based on endoscopic and pathological findings, we strongly suspected UC, and administered salazosulfapyridine and methylprednisolone, but TM and DIC developed, necessitating urgent subtotal colectomy. Despite his elderly age and the severe complications, he recovered and was discharged from our hospital about 4 months after admission. The mortality rate of UC complicated by TM and DIC in elderly patients is high, necessitating rapid initiation of high-dose steroid administration or surgical treatment.- - - - - - - - - - ranking = 1keywords = megacolon (Clic here for more details about this article) |
2/56. campylobacter jejuni-induced severe colitis--a rare cause of toxic megacolon.The development of toxic megacolon as a sequel of infectious colitis is rare. We have observed the very rare case of a campylobacter jejuni-induced toxic megacolon. A 28-year-old man was admitted with severe enterocolitis and appearance of blood in stools. He had been treated with loperamide without success. Two days after admission stool cultures revealed campylobacter jejuni and then an oral antibiotic therapy was started. On the fifth day clinical performance deteriorated again with development of toxic megacolon and consecutive subtotal colectomy. Rectoscopy before discharge after 13 days showed a normal mucosa. The unusual course with first improvement and then rapid deterioration despite adequate therapy was observed in 4 other cases, which may also be a hint of ensuing megacolon. Even in usually harmless enterocolitis like campylobacter infection, predisposing factors such as loperamide are known to precipitate toxic megacolon and should be considered in clinical practice.- - - - - - - - - - ranking = 1.8keywords = megacolon (Clic here for more details about this article) |
3/56. Toxic megacolon: a rare presentation of primary lymphoma of the colon.Primary colonic lymphoma is rare and accounts for less than 1% of colon malignancies. Moreover, diffuse neoplastic invasion of the colon is exceptional. This case describes a patient with primary non-Hodgkin's lymphoma of the colon presenting as toxic megacolon. This unique presentation is the first case reported in the literature of a diffuse colonic lymphoma diagnosed in the setting of a toxic megacolon. Histological confirmation was performed on the piece of colectomy.- - - - - - - - - - ranking = 1.2keywords = megacolon (Clic here for more details about this article) |
4/56. Toxic megacolon in Salmonella colitis: report of two cases.Toxic megacolon is a complication that usually presents in inflammatory bowel disease such as ulcerative colitis or Crohn's disease. It also occurs in typhoid fever, acute bacillary dysentery, amebic colitis, ischemic colitis, pseudomembranous colitis and severe salmonellosis. This report describes the occurrence of toxic megacolon in two young children with Salmonella colitis manifesting as abdominal distension, diarrhea and fever. The clinical course of these two cases suggests that toxic megacolon is a severe complication of salmonellosis in children, irrespective of the use of antibiotics. In the light of its paucity in children and severity, accurate diagnosis and appropriate intensive medical-surgical management is essential.- - - - - - - - - - ranking = 1.4keywords = megacolon (Clic here for more details about this article) |
5/56. Urgent colectomy in a patient with membranous tracheal disruption after severe vomiting.Implications: We report a case of a patient who developed membranous tracheal disruption after severe vomiting. He subsequently required urgent colectomy for toxic megacolon under general anesthesia. With this challenging situation, we were able to successfully conduct general anesthesia in the presence of tracheal laceration, pneumothorax, and pneumomediastinum.- - - - - - - - - - ranking = 0.2keywords = megacolon (Clic here for more details about this article) |
6/56. Toxic megacolon in a renal allograft recipient with cytomegalovirus colitis.We report a 35-year-old man, a renal allograft recipient, who presented with toxic megacolon. Segmental biopsies from the colon were consistent with cytomegalovirus colitis. serum polymerase chain reaction for cytomegalovirus dna confirmed the diagnosis. He was treated with ganciclovir but, though his abdominal condition improved initially, he worsened later and succumbed to his illness.- - - - - - - - - - ranking = 1keywords = megacolon (Clic here for more details about this article) |
7/56. Toxic megacolon due to Salmonella: a case report and review of the literature.BACKGROUND AND AIMS: Salmonella colitis is an unusual cause of toxic megacolon. We provide an overview of this condition and report a single case. patients AND methods: A 62-year-old man underwent subtotal colectomy with ileostomy formation for toxic megacolon due to salmonella enteritidis phage type 4 colitis, followed by reversal with an ileorectal anastomosis. RESULTS: Twenty-seven cases have been described in the literature. These were first treated conservatively, with antibiotics and systemic/local steroids, and some proceded to surgery. CONCLUSION: Salmonella is a rare cause of toxic megacolon, but it can behave opportunistically in patients with ulcerative colitis. S. enteritidis phage type 4 is typically transmitted via raw or uncooked eggs in most cases of salmonellosis attributed to this organism. The disease is rapidly progressive, and death may ensue due to septicaemia and/or perforation. Toxic megacolon is treated aggressively, initially medically, with high-dose steroids and attention to fluid balance, ulcerative colitis being the usual working diagnosis. Once Salmonella is cultured, appropriate antibiotics are commenced. Non-surgical decompression may be appropriate in some cases, but early surgical intervention is required for failed response to these measures or rapid deterioration in the patient's condition. Following initial surgery - often subtotal colectomy and ileostomy formation - continuity may be restored. For most patients with ulcerative colitis ileal pouch anal anastomosis is the operation of choice, but ileorectal anastomosis may be safely performed for Salmonella-induced toxic megacolon. Prevention is better than cure, and therefore health education needs to reinforce avoidance of use of raw or uncooked eggs.- - - - - - - - - - ranking = 1.8keywords = megacolon (Clic here for more details about this article) |
8/56. Toxic megacolon: a life-threatening complication of high-dose therapy and autologous stem cell transplantation among patients with AL amyloidosis.AL amyloidosis is a plasma cell disorder in which tissue deposition of immunoglobulin light chains leads to organ dysfunction. Recent reports of high-dose therapy with autologous stem cell transplantation for amyloidosis suggest higher response rates and extended survival compared to those seen with conventional chemotherapy. However, substantial treatment-related toxicity has been observed. This case series describes our institutional experience with autologous transplantation in four patients with amyloidosis with an emphasis on unique gastrointestinal toxicities, including toxic megacolon.- - - - - - - - - - ranking = 1keywords = megacolon (Clic here for more details about this article) |
9/56. shigella flexneri bacteremia in a child.We report an unusual and lethal case of shigella flexneri septicemia in an 8-year-old Saudi handicapped child from a social home presenting with severe toxic megacolon and acute abdomen secondary to fulminant necrotizing enterocolitis.- - - - - - - - - - ranking = 0.2keywords = megacolon (Clic here for more details about this article) |
10/56. Rescue therapy with tacrolimus in a patient with toxic megacolon.BACKGROUND: Toxic megacolon is a life-threatening complication most commonly observed in patients with ulcerative colitis or Crohn's disease that is characterized by total or segmental nonobstructive colonic dilatation of at least 6 cm on plain abdominal films associated with systemic toxicity. CASE REPORT: We report an unusual case of fulminant steroid-refractory ulcerative colitis complicated by toxic megacolon treated successfully with the immunosuppressant tacrolimus. CONCLUSION: tacrolimus administration induced clinical remission and bridged the time interval, until the standard immunosuppressant azathioprine could maintain clinical remission, thereby avoiding eminent emergency colectomy.- - - - - - - - - - ranking = 1.2keywords = megacolon (Clic here for more details about this article) |
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