Toxic megacolon

Classification according to ICD-10
K59.3	Megacolon, not elsewhere classified
ICD-10 online (WHO version 2019)

X-ray overview of toxic megacolon in ulcerative colitis.

A toxic megacolon is a rare but life-threatening complication, especially in ulcerative colitis , which rapidly ( fulminant ) leads to acute enlargement ( dilation ) of the large intestine (→ megacolon ) and is characterized by inflammation and a septic - toxic state. The Chagas disease , Crohn's disease or pseudomembranous colitis can lead to toxic megacolon.

Symptoms

Symptoms are, besides a painfully distended acute abdomen :

• Ileus
• shock
• high fever ( septic temperature )
• greatly increased sedimentation rate
• Tachycardia
• anemia
• Disturbances in the water-electrolyte balance

Diagnosis

The diagnosis is carried out by x-rays (→ empty abdomen image).

therapy

Preparation of a toxic megacolon

The toxic megacolon is difficult to control conservatively , so that therapy is usually performed surgically. The aim is to relieve the intestine, primarily by creating an ileostomy . Alternatively, surgical fistulization of the transverse colon with the sigmoid is possible . Radical surgery (→ proctocolectomy with ileoanal pouch anastomosis ) is the method of choice, especially for ulcerative colitis .

histology

Due to the autoreactive response of the immigrated granulocytes, the mucosa and submucosa show multiple ulcers. This mainly results in connective tissue necrosis, which can lead to dilation and perforation of the colon.

See also

• Hirschsprung's disease

literature

• J. Rüdiger Siewert: Surgery. 7th edition. Springer Verlag, Berlin 2001, ISBN 3-540-67409-8 , p. 624.

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !