506 results match your criteria: "Megacolon Acute"

Idiopathic megacolon and megarectum are rare clinical conditions characterized by irreversible dilation of the colon and rectum without an identifiable organic cause. The underlying pathophysiology remains poorly understood, though hypotheses suggest abnormalities in the enteric nervous system or smooth muscle dysfunction. These conditions present significant diagnostic and therapeutic challenges, especially in cases refractory to conservative treatment.

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Acute severe ulcerative colitis: defining the precise moment for colectomy.

Expert 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.

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Article Synopsis
  • Clostridium difficile infection (CDI) is an increasing healthcare problem linked to higher risks and poor outcomes, particularly in frail patients, whose impact on CDI has been insufficiently studied.
  • An analysis of over 144,000 adult CDI patients from the National Readmission Database revealed that 67.88% were frail, with frailty significantly increasing the risk of mortality, complications, and intensive care admission.
  • The findings suggest that frailty should be recognized as a key factor influencing CDI outcomes, which can help clinicians in better risk stratification and developing targeted treatment strategies for affected individuals.
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Purpose: The present study explores the dynamics of cell death in Hirschsprung's disease (HSCR) and control (CO) groups under inflammatory stress conditions.

Methods: Using flow cytometry, we analyzed intestinal colonic organoid cultures derived from the ganglionic segment of the HSCR and CO groups. Our analysis focused on the quantification of RIPK1-independent and RIPK1-dependent apoptosis, as well as necroptosis in both viable and non-viable cells under acute and chronic inflammatory stress.

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Article Synopsis
  • Hirschsprung's disease is a condition babies can be born with where certain nerve cells are missing from the intestines, causing problems with digestion and constipation.
  • It happens in about 1 in 5,000 newborns and is more common in boys.
  • Treatment usually involves surgery to remove the part of the intestine that doesn't work right, with special care after surgery to help kids get better and live healthier lives.
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Article Synopsis
  • Toxic megacolon (TM) is a serious condition marked by extreme dilation of the colon, often linked to inflammatory bowel disease and infections.
  • A unique case study describes a 25-year-old male with a history of recurrent constipation and cocaine use, who developed TM, requiring emergency surgery due to complications like intestinal obstruction and perforation.
  • This case emphasizes the potential dangers of chronic constipation, particularly when combined with substance use, and the need for better understanding and monitoring of such patients’ medical histories.
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Quality of life after colectomy and ileo-jpouch-anal anastomosis in paediatric patients with ulcerative colitis.

Pediatr Surg Int

August 2024

Pediatric Surgery Department, IRCCS, Istituto Giannina Gaslini, Largo Gaslini 5, 16147, Genoa, Italy.

Introduction: Ulcerative Colitis (UC) is an Inflammatory Bowel Disease (IBD). Surgery is required in cases of severe acute colitis, massive hemorrhage, toxic megacolon, and perforation; in such cases colectomy and JpouchIleoanal anastomosis (IPAA) are performed. The aim of this study was to evaluate functional outcome, and patient satisfaction and Quality of Life (QoL) after surgery.

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Profile of interstitial cells of Cajal in a murine model of chagasic megacolon.

An Acad Bras Cienc

June 2024

Universidade Federal de Ouro Preto, Departamento de Biologia e Ciências Exatas, Campus Morro do Cruzeiro, s/n, Bauxita, 35400-000 Ouro Preto, MG, Brazil.

Disorders of gastrointestinal motility are the major physiologic problem in chagasic megacolon. The contraction mechanism is complex and controlled by different cell types such as enteric neurons, smooth muscle, telocytes, and an important pacemaker of the intestine, the interstitial cells of Cajal (ICCs). The role of ICCs in the progression of acute and chronic Chagas disease remains unclear.

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Bowel Emergencies in Patients With Cancer.

Can Assoc Radiol J

February 2025

Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.

Article Synopsis
  • Cancer is the second leading cause of death globally, and as treatment improves, bowel emergencies among cancer patients are becoming more frequent due to longer survival rates.
  • The article focuses on imaging features of various bowel emergencies that occur in cancer patients, including issues like chemotherapy-related colitis and bowel obstructions.
  • Radiologists play a crucial role in diagnosing these emergencies through imaging and helping to guide subsequent treatment decisions.
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Article Synopsis
  • The text discusses a specific gram-positive coccus used in dairy fermentation, which is also a rare cause of infections in humans, particularly in amphibians and fish.
  • A case study describes a 51-year-old male who developed cholecystitis, where the pathogen was found in pus from his gallbladder.
  • Over four years, additional cases were found, resulting in severe conditions like pneumonia and gastroenteritis, with two patients dying from sepsis, highlighting the need to recognize this pathogen in serious surgical infections.
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Surgical Emergencies in Inflammatory Bowel Disease.

Surg Clin North Am

June 2024

Department of General Surgery, Madigan Army Medical Center, 9040A Jackson Avenue, JBLM, Tacoma, WA 98413, USA.

Article Synopsis
  • Inflammatory bowel disease (IBD) patients face risks for emergency surgery due to severe complications like bowel perforation and gastrointestinal hemorrhage.
  • Despite medical advancements, the rates of emergency surgeries for IBD have not significantly improved.
  • Acute care and colorectal surgeons need to be aware of the specific challenges in managing IBD patients during emergencies.
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Mediastinal and tracheal shift due to recurrent sigmoid volvulus: A case report.

SAGE Open Med Case Rep

April 2024

Department of Surgery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

We hereby present a 70-year-old male Ethiopian farmer who presented with clinical manifestations suggestive of acute large bowel obstruction, which had persisted for 3 days. Over the past 3 years, he has experienced three similar recurring episodes, which were alleviated by decompression using a rectal tube. Upon initial examination, the patient displayed signs of cardiopulmonary distress, although no indications of peritonitis were observed.

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Objective: Colectomy for ulcerative colitis (UC) is common despite therapeutic advances. Post-operative morbidity and mortality demonstrate an association between hospital volumes and outcomes. This single-centre retrospective study examines outcomes after emergency colectomy for UC.

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Adult Hirschsprung's disease (AHD) is a rare condition characterized by a shortened aganglionic segment in the distal colon or rectum that is diagnosed after the age of 10. Diagnostic challenges stem from its rarity, nonspecific presentation, and often delayed consideration following emergent interventions. This report details the case of a 33-year-old male who presented with chronic constipation and abdominal pain, leading to a severe bowel obstruction attributed to self-reported Hirschsprung's disease (HD).

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Introduction And Importance: The incidence of colorectal cancer in patients with inflammatory bowel disease is greater than the general population. Of those with inflammatory bowel disease, synchronous cancers are more common in ulcerative colitis than in Crohn's disease. It is rare for synchronous cancer to present as toxic megacolon in a patient with concomitant inflammatory bowel disease, specifically ulcerative colitis.

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RISK FACTORS FOR EARLY POSTOPERATIVE COMPLICATIONS IN ACUTE COLITIS IN THE ERA OF BIOLOGIC THERAPY.

Arq Bras Cir Dig

October 2023

Universidade de São Paulo, Coloproctology Division, Gastroenterology Department, Faculty of Medicine - São Paulo (SP), Brazil.

Background: Despite major advances in the clinical treatment of inflammatory bowel disease, some patients still present with acute colitis and require emergency surgery.

Aims: To evaluate the risk factors for early postoperative complications in patients undergoing surgery for acute colitis in the era of biologic therapy.

Methods: Patients with inflammatory bowel disease admitted for acute colitis who underwent total colectomy at a single tertiary hospital from 2012 to 2022 were evaluated.

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Article Synopsis
  • Acute severe ulcerative colitis (ASUC) is a serious medical issue that's hard to treat, especially when corticosteroids don’t work; infliximab is an alternative treatment but its best induction method isn't clear yet.* -
  • This case series discusses three patients who were resistant to corticosteroids and received different accelerated infliximab induction strategies with positive outcomes, including improved patient conditions and normalized colon imaging.* -
  • While these intensified infliximab approaches show promise, current guidelines suggest their use without providing a definitive optimal regimen due to insufficient solid evidence, with most supporting studies being retrospective and varied in severity among subjects.*
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A case report of colonic Ameboma mimicking colon cancer in an immunocompromised patient.

Int J Surg Case Rep

September 2023

Division of Trauma, Department of General Surgery, Charlotte Maxeke Johannesburg Academic Hospital, 5 Jubilee Street, Parktown, Johannesburg, South Africa. Electronic address:

Article Synopsis
  • Entamoeba histolytica is a protozoan that can cause Amoebiasis, often without symptoms, but can lead to serious conditions like bowels obstructions and chronic infections known as Ameboma.
  • A 50-year-old HIV-positive patient exhibited bowel obstruction symptoms and was diagnosed with an Entamoeba histolytica infection after surgery revealed a stricture and inflammation in the colon.
  • It's important for healthcare providers to recognize this infection as a potential cause of intestinal issues, especially in patients with risk factors like HIV, even when they don't have travel histories associated with endemic regions.
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Microbiome Alterations Driven by Infection in Two Disjunctive Murine Models.

Microbiol Spectr

June 2023

Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia.

Article Synopsis
  • Trypanosoma cruzi infection alters the gut microbiome, impacting host physiology and immune responses, which is crucial for understanding how the disease develops and finding new treatment options.
  • A study on two mouse strains showed that infection led to changes in certain inflammatory cytokines and shifts in gut bacteria, with some species decreasing and others increasing in abundance.
  • As the infection progressed, there were noticeable drops in genes related to metabolic processes, highlighting how specific bacterial losses can affect overall metabolism and disease outcomes in Chagas disease.
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Article Synopsis
  • Sigmoid volvulus is a rare bowel obstruction in kids that can be misdiagnosed, delaying treatment and causing complications.
  • In adults, it's a common issue, but there’s little research on how to treat it in children, leading to the use of adult protocols for pediatric care.
  • A 15-year-old boy had recurring sigmoid volvulus, but after imaging and studies showed no serious damage, he was treated successfully with a combination of colonoscopic decompression and laparoscopic sigmoidectomy, highlighting the need for prompt diagnosis and treatment in young patients.
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Acute colonic dilation in pediatric patients with ulcerative colitis (UC) raises a concern for toxic megacolon, but other rare conditions such as sigmoid volvulus may present in a similar manner. We report a rare case of a teenager with UC without prior surgery who developed an obstructing sigmoid volvulus managed with endoscopic detorsion and decompression. Colonic inflammation in patients with UC may result in a volvulus in the absence of other predisposing factors and should be considered in the differential diagnosis of patients with UC who present with obstructive symptoms with an atypical presentation.

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Background: In patients with acute severe ulcerative colitis with concomitant severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the treatment strategy should consider the presence of pneumonia, respiratory status, and the severity of the ulcerative colitis (UC). We report a case of a 59-year-old man with SARS-CoV-2 infection who was diagnosed with toxic megacolon caused by UC.

Case Presentation: Preoperative computed tomography scanning of the chest showed ground-glass opacities.

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Lately, emerging data suggest an association between the development of inflammatory bowel disease and anti-interleukin-17 therapy. Megacolon is a life-threatening complication of acute severe ulcerative colitis (ASUC), but its treatment has not yet been established in current practice guidelines. We report a rare case of known psoriasis treated by secukinumab in a patient who presented with ASUC and colonic dilatation.

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