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

Research output: Contribution to journalArticlepeer-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 languageEnglish
Pages (from-to)146-149
Number of pages4
JournalDigestion
Volume72
Issue number2-3
DOIs
Publication statusPublished - 2005

Keywords

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

ASJC Scopus subject areas

  • Gastroenterology

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