Toxic Megacolon Flashcards
What is it?
Causes?
Toxic megacolon describes a toxic colitis with dilatation of the colon.
The usual causes are an inflammatory colitis, secondary to inflammatory bowel disease, or an infectious colitis, which may be secondary to C. difficile.
Diagnosis
The diagnostic criteria include radiographic evidence of colonic dilation, with at least three of the following:
- fever >38.6C
- HR > 120bpm
- neutrophils >10.5 x10^9/L
- anaemia
Furthermore, one of the following must be present:
- dehydration
- confusion
- electrolyte abnormalities
- hypotension.
Management
Resuscitated with fluids
Electrolyte abnormalities should be corrected
Made nil by mouth and a nasogastric tube is used for decompression
IV antibiotics (metronidazole) are usually given, especially if there is an infective aetiology of the colitis (e.g. C. diff)
If the patient does not improve with medical management, surgery is usually required.
