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Toxic megacolon in acute fulminant ulcerative colitis

1970; Elsevier BV; Volume: 120; Issue: 6 Linguagem: Inglês

10.1016/s0002-9610(70)80046-0

1879-1883

William J. Foley, William W. Coon, Robert E. Bonfield,

Diverticular Disease and Complications

Among 150 patients having colectomy for ulcerative colitis at the University of Michigan Medical Center in the past ten years, toxic megacolon was present in twenty-eight. In almost half of these cases, the toxic megacolon developed within three months of the onset of ulcerative colitis. Perforation of the colon occurred in twelve patients (42.9 per cent). Only four cases were uncomplicated after operation and none of these had colonic perforations. Sepsis developed in all cases in which perforation had occurred, leading to death in seven instances. The mortality was 32.1 per cent. Early diagnosis of toxic megacolon can be achieved by repeated abdominal scout films in patients with acute fulminant ulcerative colitis. Prompt operation when toxic megacolon develops is advised to decrease the incidence of colonic perforation and the accompanying morbidity and mortality.