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Surgical management of toxic megacolon.
Am J Gastroenterol. 1977 Aug; 68(2):161-6.AJ

Abstract

Toxic megacolon developed in ten of 220 patients (4.5%) admitted for chronic ulcerative colitis over the past 11 years. Nine of these patients came under the care of the Surgical Department. Only three of these 10 patients had previously been treated with steroids. Steroid therapy reversed the acute process in three patients (33%). All three patients later came to surgery. Toxic megacolon developed during the first episode of ulcerative colitis in seven of ten patients (70%). Three of the seven (43%) had perforated their colons prior to operation. Two patients died after a subtotal colectomy and one without operation. A delayed diagnosis was associated with sepsis in five patients (50%) and with all three deaths. Seven patients survived proctocolectomy. Prolonged medical management without dramatic response appeared to correlate with a high postoperative morbidity. This study supports the concept of aggressive diagnosis and early surgical intervention for toxic megacolon.

Authors

Roys G
No affiliation info available
Kaplan MS
No affiliation info available
Juler GL
No affiliation info available

MeSH

Acute DiseaseAdultAgedColectomyColitis, UlcerativeColonic DiseasesFemaleHumansIntestinal PerforationMaleMegacolon, ToxicMiddle AgedPostoperative ComplicationsSepsisSteroids

Pub Type(s)

Journal Article

Language

eng

PubMed ID

920716

Citation

Roys, G, et al. "Surgical Management of Toxic Megacolon." The American Journal of Gastroenterology, vol. 68, no. 2, 1977, pp. 161-6.
Roys G, Kaplan MS, Juler GL. Surgical management of toxic megacolon. Am J Gastroenterol. 1977;68(2):161-6.
Roys, G., Kaplan, M. S., & Juler, G. L. (1977). Surgical management of toxic megacolon. The American Journal of Gastroenterology, 68(2), 161-6.
Roys G, Kaplan MS, Juler GL. Surgical Management of Toxic Megacolon. Am J Gastroenterol. 1977;68(2):161-6. PubMed PMID: 920716.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical management of toxic megacolon. AU - Roys,G, AU - Kaplan,M S, AU - Juler,G L, PY - 1977/8/1/pubmed PY - 1977/8/1/medline PY - 1977/8/1/entrez SP - 161 EP - 6 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 68 IS - 2 N2 - Toxic megacolon developed in ten of 220 patients (4.5%) admitted for chronic ulcerative colitis over the past 11 years. Nine of these patients came under the care of the Surgical Department. Only three of these 10 patients had previously been treated with steroids. Steroid therapy reversed the acute process in three patients (33%). All three patients later came to surgery. Toxic megacolon developed during the first episode of ulcerative colitis in seven of ten patients (70%). Three of the seven (43%) had perforated their colons prior to operation. Two patients died after a subtotal colectomy and one without operation. A delayed diagnosis was associated with sepsis in five patients (50%) and with all three deaths. Seven patients survived proctocolectomy. Prolonged medical management without dramatic response appeared to correlate with a high postoperative morbidity. This study supports the concept of aggressive diagnosis and early surgical intervention for toxic megacolon. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/920716/Surgical_management_of_toxic_megacolon_ L2 - https://www.diseaseinfosearch.org/result/4555 DB - PRIME DP - Unbound Medicine ER -