Toxic Dilatation of the Colon in Acute Ulcerative Colitis

McElwain, Jack W.

doi:10.1001/archsurg.1965.01320070135029

Cited by 12 publications

(3 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A third opinion states that diagnosis of toxic dilatation of the colon is in itself an indication for laparotomy as soon as corrective measures have been accomplished. Medical treatment is subsequently only considered as resuscitative and preparatory to operation [1,9,20] Medical therapy is indicated for us, but only for a limited period. If improvement is not observed after 48-72 h, management of toxic megacolon must become surgical.…”

Section: Commentsmentioning

confidence: 99%

Total colectomy with ileorectal anastomosis in surgical management of toxic megacolon

Jamart

Boissel

Debs

et al. 1983

Langenbecks Arch Chiv

View full text Add to dashboard Cite

Twenty-five patients with toxic megacolon are reported. The most frequent etiology of this syndrome was ulcerative colitis and the main complication colonic perforation. Toxic dilatation generally involved the transverse colon. Twenty patients were treated by a surgical procedure, namely two enterostomies and eighteen colectomies. A total colectomy with ileorectal anastomosis was performed in ten patients. Mortality for the whole series was 32%, but was reduced to 14% in the last 4 years. There were no deaths and no complications needing surgical management in the group of patients treated by total colectomy with ileorectal anastomosis. However, the method resulted in one failure. The satisfactory results obtained with this procedure must be emphasized. Despite the small number of so-treated patients reported in world literature, it is suggested that total colectomy with ileorectal anastomosis must be regarded as the procedure of choice for toxic megacolon without peritonitis.

show abstract

Section: Commentsmentioning

confidence: 99%

Total colectomy with ileorectal anastomosis in surgical management of toxic megacolon

Jamart

Boissel

Debs

et al. 1983

Langenbecks Arch Chiv

View full text Add to dashboard Cite

show abstract

“…Delay in surgical intervention is largely explained by failure to establish the diagnosis expeditiously and by prolonged medical treatment, often with failure to appreciate deterioration in the patient's condition until perforation has already supervened 6,13,14,15 .…”

Section: Discussionmentioning

confidence: 99%

“…In general, medical treatment can reverse the toxic megacolon in only some 30% of cases 12 ' 161 . Moreover, in 20% of these patients toxic megacolon recurs and emergency surgery is required; furthermore in 60%, surgery is ultimately required for the control of the colitis 14,15,17,20, . From these figures it is reasonable to conclude that steroids rarely reverse toxic megacolon and rarely obviate the ultimate necessity for surgical excision of the colon.…”

Section: Discussionmentioning

confidence: 99%

Management of Toxic Megacolon

Chare

Aubrey

1982

Int J Clinical Practice

View full text Add to dashboard Cite

Toxic megacolon is a rare complication of ulcerative colitis; this report describes 8 patients, 4 of whom died. The high mortality was attributable to prolonged medical treatment, delay in recognising the need to undertake surgery and colonic perforation. Our findings suggest that steroids have no place in the management of this condition; rather the occurrence of toxic megacolon should be regarded as an absolute indication for surgery with patients being selected for either total colectomy or pan-proctocolectomy.

show abstract