Archive for the ‘Toxic megacolon’ Category

Advances in the diagnosis and management of toxic megacolon (Part 5)

However, the blowhole decompression procedure is performed only rarely and the reported experience with this procedure is, therefore, limited to a few centres. Looking to the future, the authors noted that NO levels are increased in cases of TM, and this may represent a key pathway driving the toxic dilation. Recent work suggests that the […]

Advances in the diagnosis and management of toxic megacolon (Part 4)

Some physicians are comfortable managing persistent megacolon for up to seven days in patients with no overt signs of perforation or worsening toxicity. Practically, the decision to proceed with surgery is almost certainly made on a case-by-case basis with a view to the patient’s present condition and comorbidities. It is important to note that, if […]

Advances in the diagnosis and management of toxic megacolon (Part 3)

They were able to find only a single, small prospective study that identified gastric and small bowel distension as a significant predictor of a poor outcome in TM. Based on this review, we would emphasize the importance of a global assessment, including serial clinical examinations, laboratory tests and abdominal radiographs, when considering a diagnosis of […]

Advances in the diagnosis and management of toxic megacolon (Part 2)

To diagnose TM, the physician must rely on a combination of clinical criteria and radiographical evidence of dilation, as described by Jalan et al in 1969 . Gan and Beck outline the limited data to support the use of CT or other techniques for the diagnosis of TM. We discovered an article, written since their […]

Advances in the diagnosis and management of toxic megacolon (Part 1)

For 50 years, researchers and clinicians have studied the causes, pathophysiology and treatment of toxic megacolon (TM), and Gan and Beck summarized these efforts in their review. Patients diagnosed with TM are faced with a possibly fatal condition that may require intensive care and a prolonged hospital stay. Certainly the varied causes of TM are […]

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