title: Could the complications of megacolon be avoided by monitoring the risk patients? cases report.
abstract: We report 2 cases of megacolon associated with cerebrovascular accident and neuropsychiatric drug consumption. Case report 1: a 75-year-old woman with diabetes mellitus, hypertension, tachycardia with atrial fibrillation, bilateral pleural effusions and previous cerebral hemorrhage was admitted in our hospital. She presented clouded sensorium and abdominal distension, with closed alvus. The CT scan showed a distension of the colon, with severe fecal impaction. A volvulus of the sigma was found at surgical intervention.Case report 2: a 59-year-old man with a medical history of oligophrenia was admitted to our hospital for acute abdomen.He presented stupor and closed alvus with abdominal distension. The abdominal CT scan showed a dolichosigma, with fecal impaction. The patient was submitted to a laparotomy and a two millimetres perforation of the sigma was found.The sigma had a diameter of 28 cm and a length of 75 cm.Even if a clear correlation has not been found yet, anomalies of the regulation of the gastro-intestinal motility can occur at different levels in patients with psychiatric or cerebrovascular diseases and drug consumption with anticholinergic properties,and they should be carefully monitored. The purpose is an early diagnosis of colon function anomalies in order to avoid potentially fatal complications.
authors.forename: A
authors.initials: A
authors.lastname: Toro
authors.forename: G
authors.initials: G
authors.lastname: Cappello
authors.forename: M
authors.initials: M
authors.lastname: Mannino
authors.forename: I
authors.initials: I
authors.lastname: Di Carlo
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications; D018680:Cholinergic Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D003082:Colectomy; D012809:Colon, Sigmoid / Q000473:pathology* / Q000601:surgery; D003125:Colostomy; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008607:Intellectual Disability / Q000150:complications / Q000188:drug therapy; D007416:Intestinal Perforation / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D045822:Intestinal Volvulus / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D008297:Male; D008531:Megacolon / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008875:Middle Aged; D010996:Pleural Effusion / Q000150:complications; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000150:complications; D013610:Tachycardia / Q000150:complications; D016896:Treatment Outcome
chemical_list: D018680:Cholinergic Antagonists