Early surgery for the treatment of toxic megacolon

Carmelo D'Amico; Alessandro Vitale; Imerio Angriman; Cesare Ruffolo; Francesco D'Amico; Domenico Valente; Maurizio Berto; Vincenzo Vella; Marco Scarpa; Davide Francesco D'Amico

doi:10.1159/000088369

Early surgery for the treatment of toxic megacolon

Carmelo D'Amico, Alessandro Vitale, Imerio Angriman, Cesare Ruffolo, Francesco D'Amico, Domenico Valente, Maurizio Berto, Vincenzo Vella, Marco Scarpa, Davide Francesco D'Amico

Istituto Oncologico Veneto

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Toxic megacolon (TM) is a potentially lethal complication of idiopathic inflammatory bowel disease or infectious colitis, characterized by total or segmental non-obstructive colonic dilatation of at least 6cm associated with systemic toxicity. Methods: Overall, 15 patients had surgery for TM at our institutions over a 10-year period (1993-2003). In contrast to other studies that used medical therapy as the first-line treatment for TM, in our experience all patients underwent surgery as soon as possible after diagnosis of TM (early surgery). Results: 14 patients underwent subtotal colectomy with terminal ileostomy, while for 1 patient the surgical procedure consisted only in a decompressive cecostomy. Two major complications occurred consisting of 2 cases of multiple organ failure leading to death. No other major complications or deaths were reported. The overall mortality rate was therefore 13% (0% in patients

Original language	English
Pages (from-to)	146-149
Number of pages	4
Journal	Digestion
Volume	72
Issue number	2-3
DOIs	https://doi.org/10.1159/000088369
Publication status	Published - 2005

Keywords

Non-surgical therapy
Surgery for toxic megacolon
Timing of surgery
Toxic megacolon

ASJC Scopus subject areas

Gastroenterology

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10.1159/000088369

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title = "Early surgery for the treatment of toxic megacolon",

abstract = "Background: Toxic megacolon (TM) is a potentially lethal complication of idiopathic inflammatory bowel disease or infectious colitis, characterized by total or segmental non-obstructive colonic dilatation of at least 6cm associated with systemic toxicity. Methods: Overall, 15 patients had surgery for TM at our institutions over a 10-year period (1993-2003). In contrast to other studies that used medical therapy as the first-line treatment for TM, in our experience all patients underwent surgery as soon as possible after diagnosis of TM (early surgery). Results: 14 patients underwent subtotal colectomy with terminal ileostomy, while for 1 patient the surgical procedure consisted only in a decompressive cecostomy. Two major complications occurred consisting of 2 cases of multiple organ failure leading to death. No other major complications or deaths were reported. The overall mortality rate was therefore 13% (0% in patients ",

keywords = "Non-surgical therapy, Surgery for toxic megacolon, Timing of surgery, Toxic megacolon",

author = "Carmelo D'Amico and Alessandro Vitale and Imerio Angriman and Cesare Ruffolo and Francesco D'Amico and Domenico Valente and Maurizio Berto and Vincenzo Vella and Marco Scarpa and D'Amico, {Davide Francesco}",

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journal = "Digestion",

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T1 - Early surgery for the treatment of toxic megacolon

AU - D'Amico, Carmelo

AU - Vitale, Alessandro

AU - Angriman, Imerio

AU - Ruffolo, Cesare

AU - D'Amico, Francesco

AU - Valente, Domenico

AU - Berto, Maurizio

AU - Vella, Vincenzo

AU - Scarpa, Marco

AU - D'Amico, Davide Francesco

PY - 2005

Y1 - 2005

N2 - Background: Toxic megacolon (TM) is a potentially lethal complication of idiopathic inflammatory bowel disease or infectious colitis, characterized by total or segmental non-obstructive colonic dilatation of at least 6cm associated with systemic toxicity. Methods: Overall, 15 patients had surgery for TM at our institutions over a 10-year period (1993-2003). In contrast to other studies that used medical therapy as the first-line treatment for TM, in our experience all patients underwent surgery as soon as possible after diagnosis of TM (early surgery). Results: 14 patients underwent subtotal colectomy with terminal ileostomy, while for 1 patient the surgical procedure consisted only in a decompressive cecostomy. Two major complications occurred consisting of 2 cases of multiple organ failure leading to death. No other major complications or deaths were reported. The overall mortality rate was therefore 13% (0% in patients

AB - Background: Toxic megacolon (TM) is a potentially lethal complication of idiopathic inflammatory bowel disease or infectious colitis, characterized by total or segmental non-obstructive colonic dilatation of at least 6cm associated with systemic toxicity. Methods: Overall, 15 patients had surgery for TM at our institutions over a 10-year period (1993-2003). In contrast to other studies that used medical therapy as the first-line treatment for TM, in our experience all patients underwent surgery as soon as possible after diagnosis of TM (early surgery). Results: 14 patients underwent subtotal colectomy with terminal ileostomy, while for 1 patient the surgical procedure consisted only in a decompressive cecostomy. Two major complications occurred consisting of 2 cases of multiple organ failure leading to death. No other major complications or deaths were reported. The overall mortality rate was therefore 13% (0% in patients

KW - Non-surgical therapy

KW - Surgery for toxic megacolon

KW - Timing of surgery

KW - Toxic megacolon

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ER -

Early surgery for the treatment of toxic megacolon

Abstract

Keywords

ASJC Scopus subject areas

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