title: [Ulcerations in Chagas' megacolon operated at urgency and electively].
abstract: BACKGROUND
  [corrected] The megacolon is a frequent disease in our emergencie hospital, and approached in the urgency by your complications as fecal impaction, volvulus and perforations. The ulcerations in the megacolons contribute as probable sites of perforations
  
  
  OBJECTIVE
  To compare the frequencies of stercoral ulceration in Chagas' megacolon operated at urgency, by volvulus or fecal impaction, and electively, aiming at a better surgical conduct in the urgency surgery
  
  
  METHODS
  It was analyzed 356 anatomy-pathological exams from colon resection of operated patients due to Chagas' megacolon at urgency (102 cases; 29%) and electively (254 cases; 71%), from 1980 to 2000. The surgical urgency indications were attributed to volvulus (71 cases; 69,6%), fecal impaction (25 cases; 24,5%), perforated acute abdomen after rectal catheter or sigmoidoscopy (6 cases; 5,9%). The ulceration frequency was compared in both groups of resections, using chi-square
  
  
  RESULTS
  The pathological anatomy - of surgery resection obtained at urgency surgeries, showed 26 cases of ulceration (25,5%) and in electively resections were verified 21 cases of ulceration (8,25%). The difference observed was statistically significant. The comparison among the groups of volvulus; fecal impaction and volvulus with fecal impaction, separately with electively surgery group evidenced significant differences in relation to volvulus and fecal impaction
  
  
  CONCLUSIONS
  The higher frequency of ulcerations in the megacolon operated at urgency character emphasizes the needs of immediate resection of sigmoid colon, instead of conservative conduct of simple decompression colostomy, even in exploration laparotomy which the macroscopic examination of sigmoid does not show necrotic signs. This way, should prevent the occurrence of perforation in megacolon at mediate postoperative, with serious results.
authors.affiliation: Departamento de Cirurgia, Universidade Federal de Uberlândia, MG. diogofilho@netsite.com.br
authors.forename: Augusto
authors.initials: A
authors.lastname: Diogo-Filho
authors.forename: Ademir
authors.initials: A
authors.lastname: Rocha
authors.forename: Daniel Oliveira
authors.initials: DO
authors.lastname: De Conti
authors.forename: Karina Vasconcelos
authors.initials: KV
authors.lastname: Ferreira
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014355:Chagas Disease / Q000150:complications / Q000473:pathology* / Q000601:surgery; D016009:Chi-Square Distribution; D003082:Colectomy / Q000009:adverse effects; D017558:Elective Surgical Procedures; D004638:Emergency Treatment; D005244:Fecal Impaction / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D045822:Intestinal Volvulus / Q000209:etiology / Q000473:pathology; D008297:Male; D008531:Megacolon / Q000150:complications / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D003668:Pressure Ulcer / Q000209:etiology / Q000473:pathology*; D012189:Retrospective Studies; D016896:Treatment Outcome