Document Detail

Early surgery for the treatment of toxic megacolon.
MedLine Citation:
PMID:  16172551     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Toxic megacolon (TM) is a potentially lethal complication of idiopathic inflammatory bowel disease or infectious colitis, characterized by total or segmental non-obstructive colonic dilatation of at least 6 cm associated with systemic toxicity. METHODS: Overall, 15 patients had surgery for TM at our institutions over a 10-year period (1993-2003). In contrast to other studies that used medical therapy as the first-line treatment for TM, in our experience all patients underwent surgery as soon as possible after diagnosis of TM (early surgery). RESULTS: 14 patients underwent subtotal colectomy with terminal ileostomy, while for 1 patient the surgical procedure consisted only in a decompressive cecostomy. Two major complications occurred consisting of 2 cases of multiple organ failure leading to death. No other major complications or deaths were reported. The overall mortality rate was therefore 13% (0% in patients <65 years). CONCLUSION: This study shows that early surgery has the potential to represent a valid therapeutic strategy for patients with TM resulting in a small number of TM-related complications and deaths. Elderly patients seem to have a high risk of multiple organ dysfunction syndrome and post-surgical death.
Carmelo D'Amico; Alessandro Vitale; Imerio Angriman; Cesare Ruffolo; Francesco D'Amico; Domenico Valente; Maurizio Berto; Vincenzo Vella; Marco Scarpa; Davide Francesco D'Amico
Publication Detail:
Type:  Journal Article     Date:  2005-09-16
Journal Detail:
Title:  Digestion     Volume:  72     ISSN:  0012-2823     ISO Abbreviation:  Digestion     Publication Date:  2005  
Date Detail:
Created Date:  2005-10-25     Completed Date:  2006-01-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0150472     Medline TA:  Digestion     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  146-9     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2005 S. Karger AG, Basel.
Dipartimento di Chirurgia Generale, Piove di Sacco, University of Padua, Padua, Italy.
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MeSH Terms
Aged, 80 and over
Chi-Square Distribution
Megacolon, Toxic / surgery*
Middle Aged
Postoperative Complications
Survival Rate
Treatment Outcome

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