Toxic megacolon

Sheth, Sunil G.; LaMont, J. Thomas

doi:10.1016/s0140-6736(97)10475-5

Cited by 173 publications

(137 citation statements)

References 42 publications

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“…Th e absolute dimension to defi ne a " megacolon " has been variably defi ned and may be considered as total or segmental nonobstructive dilation to ≥ 6 cm. Hypokalemia or hypomagnesemia, which can exacerbate dilation, should be aggressively corrected ( 260,261 ). In patients with either toxic signs (fever, leukocytosis, or worsening symptoms) or megacolon, medications with anticholinergic or narcotic properties should be avoided for possibility of worsening colonic atony or dilatation, as increased colonic and small intestinal gas is a predictor of a poor outcome to medical therapy ( 262 -265 ).…”

Section: The Patient With Severe Colitis Refractory To Maximal Oral Tmentioning

confidence: 99%

Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee

Kornbluth

Sachar

2010

American Journal of Gastroenterology

1,140

977

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Guidelines for clinical practice are aimed to indicate preferred approaches to medical problems as established by scientifi cally valid research. Double-blind placebo controlled studies are preferable, but compassionate-use reports and expert review articles are used in a thorough review of the literature conducted through Medline with the National Library of Medicine. When only data that will not withstand objective scrutiny are available, a recommendation is identifi ed as a consensus of experts. Guidelines are applicable to all physicians who address the subject regardless of specialty training or interests and are aimed to indicate the preferable but not necessarily the only acceptable approach to a specifi c problem. Guidelines are intended to be fl exible and must be distinguished from standards of care, which are infl exible and rarely violated. Given the wide range of specifi cs in any healthcare problem, the physician must always choose the course best suited to the individual patient and the variables in existence at the moment of decision. Guidelines are developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee and approved by the board of trustees. Each has been intensely reviewed and revised by the Committee, other experts in the fi eld, physicians who will use them, and specialists in the science of decision analysis. The recommendations of each guideline are therefore considered valid at the time of composition based on the data available. New developments in medical research and practice pertinent to each guideline will be reviewed at a time established and indicated at publication to assure continued validity. The recommendations made are based on the level of evidence found. Grade A recommendations imply that there is consistent level 1 evidence (randomized controlled trials), grade B indicates that the evidence would be level 2 or 3, which are cohort studies or case -control studies. Grade C recommendations are based on level 4 studies, meaning case series or poor-quality cohort studies, and grade D recommendations are based on level 5 evidence, meaning expert opinion.

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Section: The Patient With Severe Colitis Refractory To Maximal Oral Tmentioning

confidence: 99%

Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee

Kornbluth

Sachar

2010

American Journal of Gastroenterology

1,140

977

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“…(1) Dehydration (2) Altered sensorium (3) Electrolyte disturbances (4) Hypotension [17] Consider subtotal colectomy with preservation of rectum as the surgical procedure of choice in a patient with a toxic megacolon. Colonoscopies should be avoided in patients with a suspected toxic megacolon due to potential for perforation of the affected bowel.…”

Section: Toxic Megacolonmentioning

confidence: 99%

Clostridium difficile Colitis, Treatment and Management

Hasty

Barbato

Valdés

et al. 2013

Curr Emerg Hosp Med Rep

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“…Perforasyon riski yüksektir; Clostridium toksini pozitif olabilir, gram negatif ve aneorobik mikroorganizmalar için genifl spektrumlu antibiyotik ve steroid tedavisi, s›v› elektrolit dengesinin ayarlanmas› ve hastan›n monitorizasyonu gereklidir. Genellikle acil kolektomi gerektiren bir durumdur (46).…”

Section: üLseratif Kolit (üK)unclassified

Kronik enflamatuar barsak hastalıkları

Çokuğraş¹

2011

tpa

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Toxic megacolon

Cited by 173 publications

References 42 publications

Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee

Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee

Clostridium difficile Colitis, Treatment and Management

Kronik enflamatuar barsak hastalıkları

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