[Toxic megacolon. Apropos 3 cases].
The authors describe their experience with three cases of toxic megacolon: two cases were complications of an ulcerative colitis and died after surgery; one case was a complication of Crohn's disease and recovered after medical resuscitation treatment. Diagnosis was based on clinical features and direct abdominal X-ray showing an evident dilatation of the colon. The authors think that intense medical treatment has to be carried out in all cases without urgent surgical indication: even if not always successful, a medical therapy will be an appropriate preparation for operation. The authors believe that the operation of choice is colectomy with ileo-rectal anastomosis plus upstream protective ileostomy or right terminal ileostomy plus left iliac sigmoidostomy with subsequent reconstruction of continuity.
Cortesi
N
N
Clinica Chirurgica II, Chirurgia d'Urgenza, Università degli Studi, Modena.
Rossi
A
A
Barberini
G
G
Gibertini
G
G
Giliberti
G
G
Manenti
A
A
D000368:Aged; D003082:Colectomy; D004630:Emergencies; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008532:Megacolon, Toxic / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D008875:Middle Aged