Toxic megacolon

Toxic megacolon

    * Introduction
    * Symptoms and Diagnosis
    * Treatment
Toxic megacolon is the clinical term for acute colitis, toxic dilation partiala.Caracteristicile colonului.Dilatarea be complete or disease, potentially fatal, neobstructiva dilatation of the colon are more than 6 cm and signs of systemic toxicity. In the past it was thought that this is a complication of toxic colon can actually ulcerative.De colitis complicating inflammatory colitis, ischemic, infectious, pseudomembranous, and irradiation. Is very high incidence of toxic megacolon in pseudomembranous colitis. Dilation colony may be present in other diseases, such as Hirschsprung's disease, idiopathic megacolon, chronic constipation and pseudoobstructia intestinala.Dar these patients do not develop systemic toxemia and toxic colon is not included in the category. Acolonului rapid distention can cause these symptoms: Abdominal pain- -Abdominal distension -Abdominal tenderness to palpation and spontaneous -Fever, dehydration Cardiovascular-tachycardia and shock. Treatment consists in reducing colonic distension to decrease the risk of perforation, correcting dehydration by administration of fluids and electrolyte solutions and precipitating factors and treatment of toxemia. The mortality rate for toxic megacolon have decreased in the last decade from 20% to 4%, due recognition for diagnosis, improved surgical techniques and postoperative surveillance.

Pathogenesis Precise pathogenesis of toxic megacolon is unproven, though some factors were found to be involved in the evolution bolii.Frecvent symptoms and complications can occur after eating certain medications: antidepressants, loperamide, opiates, anticholinergics, steroids, such as investigators AINS.Proceduri with barium radiology or colonoscopy can cause distension, or exacerbate intestinal microperforarea. In uncomplicated colitis, inflammatory response is present only in microscopic mucoasa.Caracteristica toxic megacolon is the extension of inflammation in serosal smooth muscle layer. Mienteric plexus involvement is often seen and not contribute to the expansion. As the inflammation progresses in the muscular layer of the colon, nitric oxide appears to play an important role in patogenie.Acesta inhibits smooth muscle tone and is free of neutrophils and macrophages.

Causes Although it is recognized as a complication of ulcerative rectocolitei bleeding, toxic megacolon may also occur in other colitis, volvulus, diverticulitis, and obstructive colon cancer. Clinical manifestations suggests that the cause hemorrhagic ulcerative colitis include: history of diarrhea, blood stools, abdominal pain, perianal disease, or manifestations extradigestive arthritis, skin or liver iritamafectari. Risk factors in the development of severe colitis infection C difficile infection include malignancy, COPD, immunosuppressive therapy, renal failure or exposure to medication antiperistaltica: clindamicina.Megacolonul toxicity was observed in patients with infection caused by Clostridium difficile. Salmonella, Shigella, Campylobacter are rarely complicated by toxic megacolon, and can differentiate UH colitis by endoscopy and examination may complicate histologic.Megacolonul hemolytic-uremic syndrome and secondary infection with E. coli 0157. Less than 3% of patients with toxic megacolon develops ameobiaza colony. In patients with HIV / AIDS and cytomegalovirus shows a high incidence of complication. Other causes include: -Crohn's disease, pseudomembranous colitis -Species infection with Yersinia -Radiation colitis, ischemic colitis Chemotherapy side-nonspecific colitis.