Objective: To summarize the clinical features of ulcerative colitis (UC) complicated by toxic megacolon for early diagnosis and proper treatment.
Methods: Six cases of toxic megacolon in the patients suffered from UC in Peking Union Medical College Hospital from 1983 to 2010 were analyzed, and related literature was searched and reviewed.
Results: The incidence of the toxic megacolon in the patients with UC in our center was 0.7%(6/824), which was lower than those reported in the literature. There were always risk factors triggering the disease. The prognosis of the patients was poor, even after medical care and surgery intervention. Evaluation of the patients and making right timing to perform the surgery would improve the prognosis of the patients in foreign literature.
Conclusion: It's crucial to make early diagnosis of the toxic megacolon in the patients suffered from UC. The right choice and timing to perform urgent surgery or selective surgery may improve their prognosis.
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Inn Med (Heidelb)
January 2025
Abteilung für interventionelle gastroenterologische Endoskopie, Klinik für Gastroenterologie und Hepatologie, Universitätsklinikum Essen, Essen, Deutschland.
Background: In chronic inflammatory bowel diseases (IBD), severe flares are characterized by intense inflammatory activity and a high disease burden for patients. Treatment addresses both short-term goals (e.g.
View Article and Find Full Text PDFExpert Rev Gastroenterol Hepatol
January 2025
INFINY Institute, Department of Gastroenterology, CHRU Nancy, INSERM NGERE, Université de Lorraine, Vandœuvre-lès-Nancy, France.
Introduction: Acute severe ulcerative colitis (ASUC) is a critical manifestation of ulcerative colitis (UC), often necessitating colectomy when medical management fails. Despite advancements in therapeutic interventions such as corticosteroids, biologics, and JAK inhibitors, a significant proportion of patients require surgery, with colectomy rates ranging from 10% to 15%.
Areas Covered: This paper reviews the factors influencing the timing and necessity of colectomy in ASUC management, emphasizing the importance of multidisciplinary decision-making involving gastroenterologists and surgeons.
J Surg Case Rep
December 2024
Bariatric Surgery, Obesity Goodbye Center, Tijuana 22000, Mexico.
Cureus
November 2024
General Surgery, Broward Health and South Florida Surgical Specialists, Fort Lauderdale, USA.
Fulminant colitis is a severe and potentially life-threatening form of associated bacterial disease leading to inflammation and damage to the colon. Complications such as toxic megacolon, sepsis, and multi-organ failure commonly occur in individuals with compromised immune systems and recent antibiotic use. Management of colitis involves optimization of fluid and electrolyte balance, and elimination of bacteria commonly by administering vancomycin or fidaxomicin.
View Article and Find Full Text PDFIn recent years, there has been a significant rise in both the frequency and severity of colitis. This infection presents a broad clinical spectrum, ranging from asymptomatic colonization to severe fulminant colitis, which often requires urgent surgical intervention. The failure of medical treatments and the development of toxic megacolon typically necessitate surgery, though it is associated with high mortality rates.
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