Toxic megacolon overview: Difference between revisions
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==Risk Factors== | ==Risk Factors== | ||
Common risk factors in the development of toxic negacolon include discontinuation of steroids, use of barium enemas, [[colonoscopy]], [[chemotherapy]], antidiarrheal drugs, anticholinergic drugs, [[narcotics]], Severe [[chronic obstructive pulmonary disease]], [[organ transplantation]], cardiothoracic procedures, [[diabetes mellitus]], [[immunosuppression]], [[renal failure]]. | |||
==Screening== | ==Screening== | ||
Revision as of 21:04, 27 November 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]
Overview
Historical Perspective
Toxic megacolon was first discovered by Marshak and Lester in 1950. Jalen criteria was developed by Jalen et al to diagnose toxic megacolon in 1969.
Classification
There is no established system for the classification of toxic megacolon.
Pathophysiology
Toxic megacolon results from severe inflammation extending into the smooth-muscle layer and paralyses the colonic smooth muscle leading to dilatation. The extent of dilatation associated with the depth of inflammation and ulceration. Nitric oxide, an inhibitor of smooth-muscle tone, has an important role in the pathogenesis of toxic megacolon. Nitric oxide is produced by neutrophils and smooth-muscle cells in the inflamed colon.
Causes
The most common cause of toxic megacolon include inflammatory bowel disease and Clostridium difficile pseudomembranous colitis.
Differentiating ((Page name)) from Other Diseases
Epidemiology and Demographics
The precise incidence of toxic megacolon is unknown in general population. The incidence of toxic megacolon in the associated disorders including ulcerative colitis and Crohn's disease is 1000-2500 in 100,000 cases and 4400-6300 in 100,000 cases, respectively. The mortality rate of toxic megacolon associated with Clostridium difficile is approximately 38%-80%.
Risk Factors
Common risk factors in the development of toxic negacolon include discontinuation of steroids, use of barium enemas, colonoscopy, chemotherapy, antidiarrheal drugs, anticholinergic drugs, narcotics, Severe chronic obstructive pulmonary disease, organ transplantation, cardiothoracic procedures, diabetes mellitus, immunosuppression, renal failure.