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[Toxic megacolon].
Med Klin Intensivmed Notfmed. 2015 Oct; 110(7):500-5.MK

Abstract

BACKGROUND

Toxic megacolon constitutes a feared, life-threatening complication of severe intestinal inflammation and is a challenge for interdisciplinary medical care.

OBJECTIVES

Specific aspects of conservative treatment based on current scientific evidence derived from guidelines, qualified reviews, and scientific studies are presented, which provide a rational approach and maximize therapeutic success.

MATERIALS AND METHODS

This work is based on a selective literature review and the authors' experience of many years in gastroenterology and intensive care.

RESULTS

Toxic megacolon requires a rapid interdisciplinary assessment. Depending on the underlying etiology, an individual treatment concept needs to be developed. If an infectious or inflammatory cause is probable, a conservative approach can reduce perioperative morbidity and mortality. A step-wise approach with controlled reevaluations of the response to therapy after 72 h and 7 days avoids uncontrolled delay of surgical options further ensuring patient safety.

CONCLUSION

Despite a decreasing incidence of toxic megacolon, it remains an interdisciplinary therapeutic challenge.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Leppkes M
Medizinische Klinik 1, Universitätsklinik Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Deutschland.
Ganslmayer M
Medizinische Klinik 1, Universitätsklinik Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Deutschland.
Strauβ R
Medizinische Klinik 1, Universitätsklinik Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Deutschland.
Neurath MF
Medizinische Klinik 1, Universitätsklinik Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Deutschland. markus.neurath@uk-erlangen.de.

MeSH

Colitis, UlcerativeCritical CareCritical IllnessCytomegalovirus InfectionsEnterocolitis, PseudomembranousEvidence-Based MedicineGuideline AdherenceHumansInterdisciplinary CommunicationIntersectoral CollaborationMegacolon, ToxicPrognosis

Pub Type(s)

Journal Article
Review

Language

ger

PubMed ID

26369529

Citation

Leppkes, M, et al. "[Toxic Megacolon]." Medizinische Klinik, Intensivmedizin Und Notfallmedizin, vol. 110, no. 7, 2015, pp. 500-5.
Leppkes M, Ganslmayer M, Strauβ R, et al. [Toxic megacolon]. Med Klin Intensivmed Notfmed. 2015;110(7):500-5.
Leppkes, M., Ganslmayer, M., Strauβ, R., & Neurath, M. F. (2015). [Toxic megacolon]. Medizinische Klinik, Intensivmedizin Und Notfallmedizin, 110(7), 500-5. https://doi.org/10.1007/s00063-015-0076-1
Leppkes M, et al. [Toxic Megacolon]. Med Klin Intensivmed Notfmed. 2015;110(7):500-5. PubMed PMID: 26369529.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Toxic megacolon]. AU - Leppkes,M, AU - Ganslmayer,M, AU - Strauβ,R, AU - Neurath,M F, Y1 - 2015/09/14/ PY - 2015/07/09/received PY - 2015/08/04/accepted PY - 2015/9/16/entrez PY - 2015/9/16/pubmed PY - 2017/2/14/medline KW - Clostridium difficile KW - Colitis, ulcerative KW - Cytomegalic inclusion disease KW - Intensive care KW - Pseudomembranous colitis SP - 500 EP - 5 JF - Medizinische Klinik, Intensivmedizin und Notfallmedizin JO - Med Klin Intensivmed Notfmed VL - 110 IS - 7 N2 - BACKGROUND: Toxic megacolon constitutes a feared, life-threatening complication of severe intestinal inflammation and is a challenge for interdisciplinary medical care. OBJECTIVES: Specific aspects of conservative treatment based on current scientific evidence derived from guidelines, qualified reviews, and scientific studies are presented, which provide a rational approach and maximize therapeutic success. MATERIALS AND METHODS: This work is based on a selective literature review and the authors' experience of many years in gastroenterology and intensive care. RESULTS: Toxic megacolon requires a rapid interdisciplinary assessment. Depending on the underlying etiology, an individual treatment concept needs to be developed. If an infectious or inflammatory cause is probable, a conservative approach can reduce perioperative morbidity and mortality. A step-wise approach with controlled reevaluations of the response to therapy after 72 h and 7 days avoids uncontrolled delay of surgical options further ensuring patient safety. CONCLUSION: Despite a decreasing incidence of toxic megacolon, it remains an interdisciplinary therapeutic challenge. SN - 2193-6226 UR - https://www.unboundmedicine.com/medline/citation/26369529/[Toxic_megacolon]_ DB - PRIME DP - Unbound Medicine ER -