Incidence, features, in-hospital outcomes and predictors of in-hospital mortality associated with toxicmegacolon hospitalizations in the United States. Toxicmegacolon (TM) is a potentially fatal condition characterized by non-obstructive colonic dilatation and systemic toxicity. It is most commonly caused by inflammatory bowel disease (IBD). Limited data for TM are available demonstrating
First reported case of afatinibâ€associated toxicmegacolon We report the first case of toxicmegacolon associated with afatinib use, which is a potentially fatal complication, with risks of colonic perforation. In this case, the condition improved on stopping afatnib. Clinicians need to be alert of this rare but fatal adverse effect and to avoid anti-diarrhoeal agents, which can worsen toxicmegacolon. Anti-diarrhoeal agents are routinely given if diarrhoea occurs on afatinib. These should be stopped and avoided if toxicmegacolon occurs.
Shigellosis and toxicmegacolon secondary to Shigella flexneri serotype 3a: The challenges of laboratory diagnosis. We present a rare case of Shigella flexneri bacteraemia and toxicmegacolon, and discuss the challenges of conventional laboratory techniques versus molecular PCR platforms in differentiating between Shigella species and Escherichia coli.
ToxicMegacolon – A Three Case Presentation Toxicmegacolon is a life-threatening disease and is one of the most serious complications of infection (CDI), usually needing prompt surgical intervention. Early diagnosis and adequate medical treatment are mandatory. In the last two years, three Caucasian female patients have been diagnosed with toxicmegacolon and treated in the Clinical malignancy, renal failure, obesity, and immune deficiencies. Ribotype 027, a marker for a virulent strain of CD, was found in all three cases complicated by toxicmegacolon. The intracolonic administration of vancomycin, and intravenous tigecycline was successful when prior standard therapy had failed, and surgery was avoided.
Viral spread to enteric neurons links genital HSV-1 infection to toxicmegacolon and lethality Herpes simplex virus 1 (HSV-1), a leading cause of genital herpes, infects oral or genital mucosal epithelial cells before infecting the peripheral sensory nervous system. The spread of HSV-1 beyond the sensory nervous system and the resulting broader spectrum of disease are not well understood. Using , and neutrophil-mediated destruction of enteric neurons, ultimately resulting in permanent loss of peristalsis and the development of toxicmegacolon. Laxative treatment rescued mice from lethality following genital HSV-1 infection. These results reveal an unexpected pathogenesis of HSV associated with ENS infection.
Campylobacter colitis: Rare cause of toxicmegacolon Campylobacter is the leading cause of bacterial diarrhoeal illness worldwide. Toxicmegacolon is a rare but potentially devastating complication. A 55year old female with liver cirrhosis, alcoholism and hepatitis C, presented with severe colitis and stool specimen positive for Campylobacter. She developed septic shock, multi-organ dysfunction syndrome and toxicmegacolon unresponsive to medical therapy, and underwent a subtotal colectomy with end ileostomy. Despite initial improvement, the patient died on postoperative day 4. Early surgical consultation is essential as toxicmegacolon may be complicated by perforation or uncontrolled bleeding; progressive colonic dilatation with clinical deterioration is also an important indication
Induction of potentially lethal hypermagnesemia, ischemic colitis, and toxicmegacolon by a preoperative mechanical bowel preparation: report of a case A 67-year-old man was diagnosed with rectal cancer. The tumor invaded the subserosal layer, but it was not large, and there was no sign of obstruction. Neo-adjuvant chemotherapy reduced the size of the tumor. The patient was admitted to our hospital for surgery. For mechanical bowel preparation, he ingested 34 g of magnesium citrate (Magcorol P®), but then developed severe shock, a disturbance of consciousness, and acidemia, and he required catecholamines and mechanical ventilation. X-ray, CT, and laboratory tests revealed ischemic colitis, toxicmegacolon, and hypermagnesemia (16.3 mg/dL). After 2 days of temporary hemodialysis
Fatal ToxicMegacolon in a Child of Hirschsprung Disease Hirschsprung disease (HD) in late childhood is uncommon and often undiagnosed or misdiagnosed. However, in a patient with Hirschsprung disease, of greater significance is the occurrence of life threatening enterocolitis. In its more severe form, this is associated with gross dilatation of the colon and profound toxaemia, the combination being termed toxicmegacolon. Because of its relative rarity, we report a case of 10-year-old child who had a history of chronic constipation for nine years. He later developed complications and presented to the emergency department with toxicmegacolon, a rare occurrence due to neglected constipation. Though patient's condition was unstable, laparotomy with right transverse colostomy was performed
Toxicmegacolon and interstitial pneumonia caused by cytomegalovirus infection in a pediatric patient with acute lymphoblastic leukemia receiving chemotherapy
Blowhole Colostomy for Clostridium difficile-Associated ToxicMegacolon We present the case of a 58-year-old man who underwent urgent blowhole colostomy for toxicmegacolon (TM) secondary to infection (CDI). This infection occurred under antibiotic coverage with amoxicillin-clavulanic acid, four days after laparoscopic sigmoidectomy in our hospital. Although prospective clinical research
Toxicmegacolon during pregnancy in ulcerative colitis: A case report Ulcerative colitis is an idiopathic inflammatory bowel condition whose peak incidence coincides with fertility in female patients. In pregnancy, acute fulminant colitis is rare, and, when it becomes refractory to maximum medical therapy, emergency colectomy is mandated. Over the past quarter century, there have been few reports of this rare event in the literature. We report a 26 year old primigravida female who presented with toxicmegacolon during the third trimester of pregnancy, unresponsive to medical therapy. She subsequently underwent an urgent low transverse caesarean section with a total colectomy. Both mother and child made a satisfactory recovery post operatively. Although the fetus is at higher risk than
The Surgical Treatment of ToxicMegacolon in Hirschsprung Disease. Enterocolitis remains the most significant cause of morbidity and mortality in Hirschsprung disease (HD). It could progress into toxicmegacolon (TM)-acute dilatation of the colon as accompanying toxic complication of Hirschsprung enterocolitis. It is a devastating complication, especially in infants with so far undiagnosed HD reactive protein, anemia, dehydration, electrolyte disturbances, hypotension). Surgical management and outcome was evaluated by retrospective chart review. The median duration of symptoms characteristic for TM was 3 days. Toxicmegacolon was seen as the first manifestation of previously unknown HD in 3 patients; in 1 newborn, the contrast radiograph was suggestive of HD. In all patients, conservative
); * severe ulcerative colitis (severe inflammation of the large intestine causing ulceration and bleeding); * toxicmegacolon (a very serious complication of colitis). Toviaz must not be given to patients with moderate liver or moderate to severe kidney disease at the same time as strong CYP3A4 inhibitor medicines. These include medicines such as ketoconazole and itraconazole (used to treat fungal
hypotension, partial or complete ileus, toxicmegacolon or CT evidence of severe disease. Probiotics Probiotics Probiotics are live bacteria and yeasts that are promoted as having various health benefits. They are usually added to yoghurts or taken as food supplements. They are often described as 'good', 'friendly' or 'healthy' gut bacteria, and are thought to help restore the natural balance of bacteria
not allowed to have any manifestations (e.g. abdominal abscesses, toxicmegacolon) that could have required surgery during study participation. Patients who had been treated with corticosteroids for at least 14 days before baseline, with a stable dose for at least 7 days, were eligible to participate in the study. Patients were randomly allocated to the study arms in a 1:1 ratio or interleukin inhibitors were not allowed in the SEQUENCE study. Patients with current diagnosis of ulcerative colitis or indeterminate colitis were excluded from the study. Furthermore, patients were not allowed to have any manifestations (e.g. abdominal abscesses, toxicmegacolon) that could have required surgery Extract of dossier assessment A22-133 Version 1.0 Risankizumab
, obstructive ileus, inflammatory bowel dis-ease, and toxicmegacolon. Patients starting prucalo-pride should be monitored for suicidal thoughts orbehavior and new onset or worsening depression.103Recommendation 4.3.1:•Prucalopride should be considered as an adjunct to ahigh‐dose stimulant laxative when treating RC withpoor response to optimized high‐dose stimulantlaxatives. (Agreement: 7/8).2.10.2