Endoscopic findings of intestinal Behçet’s disease complicated with toxic megacolon

Umehara, Yasuko; Kudo, Masatoshi; Kawasaki, Mikio

doi:10.1055/s-0028-1103446

Cited by 4 publications

(3 citation statements)

References 3 publications

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“…In conclusion, we report the first case in which surgery provided a favorable 5-year outcome in a patient with MDS-associated BD. As shown in Table 2, 9,10,[15][16][17][18][19][20] there is no case that surgery provides a long-term outcome like our case. The diagnosis and treatment of such patients may be complicated, but we believe that an improved understanding of this complex disease and collaborative therapy can lead to improved care and reduce adverse outcomes.…”

Section: Discussionmentioning

confidence: 80%

Long-term outcome after surgery in a patient with intestinal Behçet’s disease complicated by myelodysplastic syndrome and trisomy 8

et al. 2020

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Behçet’s disease (BD) is a multisystem inflammatory disease of unknown origin. Rarely, BD occurs together with myelodysplastic syndrome (MDS). Interestingly, it is speculated that these are not simple coexistence but that the etiology of intestinal BD is at least partly derived from MDS itself. Furthermore, there is a relationship between MDS in patients with intestinal BD and trisomy 8. Immunosuppressive agents alone are insufficient to control MDS-associated BD, and many of these patients die of infection or hemorrhage. Surgery is considered for intestinal BD patients who are unresponsive to medical treatment or those with bowel complications such as perforation or persistent bleeding. We report a case of intestinal BD associated with MDS and trisomy 8. The patient was unresponsive to oral steroids and immunosuppressive treatment; the patient improved by surgical repair of a bowel perforation. Five years after the surgery, the patient is free of recurrence and not on medication. Our experience suggests that surgery may provide an effective therapeutic option for the treatment of MDS-related BD.

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Section: Discussionmentioning

confidence: 80%

Long-term outcome after surgery in a patient with intestinal Behçet’s disease complicated by myelodysplastic syndrome and trisomy 8

et al. 2020

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“…25 Over the course of the last decades, however, the list of etiological factors was expanded by a vast array of inflammatory and infectious conditions: bacterial colitides such as C. difficile, Salmonella, 26 Shigella, 27 and Campylobacter 28 as well as viral (e.g., cytomegalovirus [CMV]) 29 and parasitic (Entameba) 30 infections may be complicated by colonic dilatation. Further etiological factors include ischemic colitis, 31 Behçet's disease, 32 and malignancies like colonic lymphoma 33 and Kaposi's sarcoma. There have been case reports of aspergillosis, 34 collagenous colitis, 35 and rotavirus 36 involved in toxic megacolon.…”

Section: Etiologymentioning

confidence: 99%

Toxic megacolon

and

Baumgart

2012

Inflammatory Bowel Diseases

121

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Toxic megacolon represents a dreaded complication of mainly inflammatory or infectious conditions of the colon. It is most commonly associated with inflammatory bowel disease (IBD), i.e., ulcerative colitis or ileocolonic Crohn's disease. Lately, the epidemiology has shifted toward infectious causes, specifically due to an increase of Clostridium difficile-associated colitis possibly due to the extensive (ab)use of broad-spectrum antibiotics. Other important infectious etiologies include Salmonella, Shigella, Campylobacter, Cytomegalovirus (CMV), rotavirus, Aspergillus, and Entameba. Less frequently, toxic megacolon has been attributed to ischemic colitis, collagenous colitis, or obstructive colorectal cancer. Toxic colonic dilatation may also occur in hemolytic-uremic syndrome (HUS) caused by enterohemorrhagic or enteroaggregative Escherichia coli O157 (EHEC, EAEC, or EAHEC). The pathophysiological mechanisms leading to toxic colonic dilatation are incompletely understood. The main characteristics of toxic megacolon are signs of systemic toxicity and severe colonic distension. Diagnosis is made by clinical evaluation for systemic toxicity and imaging studies depicting colonic dilatation. Plain abdominal imaging is still the most established radiological instrument. However, computed tomography scanning and transabdominal intestinal ultrasound are promising alternatives that add additional information. Management of toxic megacolon is an interdisciplinary task that requires close interaction of gastroenterologists and surgeons from the very beginning. The optimal timing of surgery for toxic megacolon can be challenging. Here we review the latest data on the pathogenesis, clinical presentation, laboratory, and imaging modalities and provide algorithms for an evidence-based diagnostic and therapeutic approach.

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“…Toxic megacolon was initially described as a complication of ulcerative colitis, then in various forms of colitis: inflammatory, ischemic, infectious, after x-ray, unspecific colitis secondary to chemotherapy [18,19], complication of the collagenous colitis [20,21], colitis from the Behcet syndrome [22,23], Kaposi syndrome [24] and pseudomembranous colitis after therapy with methotrexate.…”

Section: Introductionmentioning

confidence: 99%

Clostridium Difficile Infection Complicated By Toxic Megacolon In Immunocompetent Patient

Draganescu

Baroiu

Iancu

et al. 2017

ARS Medica Tomitana

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Endoscopic findings of intestinal Behçet’s disease complicated with toxic megacolon

Cited by 4 publications

References 3 publications

Long-term outcome after surgery in a patient with intestinal Behçet’s disease complicated by myelodysplastic syndrome and trisomy 8

Long-term outcome after surgery in a patient with intestinal Behçet’s disease complicated by myelodysplastic syndrome and trisomy 8

Toxic megacolon

Clostridium Difficile Infection Complicated By Toxic Megacolon In Immunocompetent Patient

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