Cureus
December 2024
General Surgery, King's College Hospital London, Dubai Hills, Dubai, ARE.
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.
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.
Clin Res Hepatol Gastroenterol
November 2024
Department of Gastroenterology, Cleveland Clinic Florida, FL, USA.
Pediatr Surg Int
November 2024
Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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.
J Med Life
June 2024
Department of Pharmaceutical Sciences, Vasile Goldiş Western University of Arad, Arad, Romania.
Front Surg
August 2024
Surgery Unit, Hospital General de México (HGM), Mexico City, Mexico.
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.
View Article and Find Full Text PDFAn 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.
View Article and Find Full Text PDFCan Assoc Radiol J
February 2025
Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
Surg Infect (Larchmt)
May 2024
Meritus Health, Hagerstown, Maryland, USA.
Surg Clin North Am
June 2024
Department of General Surgery, Madigan Army Medical Center, 9040A Jackson Avenue, JBLM, Tacoma, WA 98413, USA.
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.
View Article and Find Full Text PDFEur J Gastroenterol Hepatol
May 2024
Department of Colorectal Surgery, Beaumont Hospital, Dublin, Ireland.
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.
View Article and Find Full Text PDFCureus
November 2023
General Surgery, Campbell University School of Osteopathic Medicine, Lillington, USA.
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).
View Article and Find Full Text PDFInt J Surg Case Rep
November 2023
Department of Surgery, Central Michigan University College of Medicine, United States of America.
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.
View Article and Find Full Text PDFArq 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.
GE Port J Gastroenterol
October 2023
Gastroenterology Department, Hospital de Braga, Braga, Portugal.
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:
ANZ J Surg
December 2023
Colorectal Surgery Department, St Vincent's Public Hospital Melbourne, Melbourne, Victoria, Australia.
Microbiol Spectr
June 2023
Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia.
ACG Case Rep J
February 2023
Department of Pediatric Gastroenterology, Hepatology and Nutrition, Cleveland Clinic Children's, Cleveland, OH.
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.
View Article and Find Full Text PDFSurg Case Rep
February 2023
Department of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, 501-1194, Japan.
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.
Case Rep Gastroenterol
February 2023
Department of Gastroenterology, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam.
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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