Toxic Megacolon (General Surgery EOR - Smarty PANCE)

What is toxic megacolon?

Toxic megacolon is a life-threatening complication characterized by rapid dilatation of the colon, often associated with inflammatory bowel disease (IBD) or infections.

● Toxic patient: sepsis, febrile, abdominal pain

● Megacolon: acutely and massively distended colon

What are the typical symptoms of toxic megacolon?

Symptoms may include severe abdominal pain, distension, fever, rapid heart rate, dehydration, and shock.

What are the common underlying causes of toxic megacolon?

Inflammatory bowel diseases (such as ulcerative colitis), Clostridium difficile infection, and other bacterial infections are common causes.

Incidence of toxic megacolon in Crohn's disease?

5%

Incidence of toxic megacolon in Ulcerative Colitis?

10%

What diagnostic tests are utilized for toxic megacolon?

Abdominal X-rays showing a dilated colon, blood tests showing elevated inflammatory markers, and clinical evaluation are essential in diagnosis.

What are the key radiographic findings in toxic megacolon?

On an abdominal X-ray, a dilated colon with a diameter greater than 6 cm, loss of haustral markings, and signs of inflammation are key findings.

What is the initial medical treatment for toxic megacolon?

Initial treatment includes bowel rest, IV fluids, electrolyte replacement, antibiotics if infection is present, and close monitoring in an intensive care setting.

When is surgical intervention indicated in toxic megacolon?

Surgery is indicated if there's evidence of perforation, persistent symptoms despite medical management, or increasing colonic dilatation.

What surgery is commonly performed for toxic megacolon?

Total colectomy with end ileostomy is often performed for toxic megacolon to remove the affected colon.

What are potential complications of toxic megacolon?

Possible complications include perforation, sepsis, multi-organ failure, and death.

Why is early recognition and intervention important in toxic megacolon?

Early recognition and aggressive treatment are vital to prevent life-threatening complications and improve outcomes, as the condition can rapidly deteriorate.