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Gastrointestinal
Toxic Megacolon
14
Medical
Graduate
01/21/2010

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Term
What is Hirschsprung disease?
Definition
congenital aganglionic megacolon
Term
Is Hirschsprung's more common in boys or girls?
Definition
Boys 4X greater
Term
10-15% of infants w/ Hirschsprung also have what condition?
Definition
Down's syndrome
Term
Toxic megacolon is a complication of what diseases?
Definition
UC (most common), Crohn's, and c.diff
Term
Other than IBD and c.diff, what can cause toxic megacolon?
Definition
Colitis from ambeiasis and salmonellosis, hypokalemia, opiod or anticholinergic use, barium enema
Term
What s/sx occur in toxic megacolon?
Definition
Fever, abd pain/distension, diarrhea (often bloody), tachycardia, rapid progression of sx X 1-2wks
Term
What lab findings are expected in toxic megacolon?
Definition
neutrophilic leukocytosis, anemia
Term
What test is critical for dx and following the course of toxic megacolon?
Definition
Plain abd x-ray
Term
What findings are expected on abd x-ray of toxic megacolon?
Definition
transverse colon dilation >6cm, haustral pattern disturbed or absent
Term
What is the tx for toxic megacolon?
Definition
Hospitalization, NPO, NG suction
Term
What meds should be used to tx toxic megacolon d/t IBD? If severely ill?
Definition
IV corticosteroids (hydrocortisone or methylprednisone). Broad spectrum IV abx.
Term
What are indications for surgery in a pt w/ toxic megacolon?
Definition
Perforation, massive hemorrhage, worsening signs of toxicity, failure to improve in 48-72hrs
Term
What surgery is used to tx toxic megacolon?
Definition
Partial or total colectomy w/ ileoanal anastamosis
Term
What cause of toxic megacolon has the highest mortality rates?
Definition
c.diff
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