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GI - Toxic Megacolon
PA CLin Med
11
Health Care
Graduate
01/12/2010

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Term
define toxic megacolon:
Definition
potentially lethal complication of inflammatory bowel dz or infectious colitis, characterized by non-obstructive dilatation w systemic toxicity
Term
Congenital aganglionic megacolon: AKA
Definition
Hirschsprung's Dz
Term
3 points of epidemiology for Hirschsprung's:
Definition
1. mostly affects rectosigmoid colon
2. Boys 4:1
3. 10-15% of hirschsprungs are Down's kids
Term
etiology of toc=xic megacolon:
Definition
1. Ulcerative colitis (most common)
2. Crohn's
3. abx
4. pseudomembraneous colitis (C-Diff)
Term
the term toxic in "toxic megacolon" means:
Definition
this complication occurs with infection or inflammation
Term
S/Sx of toxic megacolon:5
Definition
1. Fvr (>38C)
2. Abd pain
3. Abd distension
4. diarrhea (often bloody)
5. rapid progression of sx over 1-2wks
6. Tachycardia >120
Term
what is seen on x-rays of toxic megacolon?
Definition
1. transverese colon dilatation of >6cm
2. multiple air/fluid levels
3. haustral pattern disturbed or absent
4. ascending or transverse usually most dilated
Term
Tx/management of toxic megacolon:8
Definition
1. admit
2. NPO
3. NG
4. IV
5. abx
6. correct hypokalemia
7. rectal tube; (decompress distented colon)
8. serial plain films to monitor
Term
why is hypokalemia a risk factor for toxic megacolon?
Definition
lack of K+ slows down peristalsis, stasis of feces causes infection/inflammation
Term
5 indications for surgical correction of toxic megacolon:
Definition
1. perforation
2. massive hemorrhage
3. increasing signs of toxicity
4. increasing dilatation
5. failure to improve within 48-72hrs
Term
prognosis for toxic megacolon:
Definition
good 95% success rate, highest mortalities with C-Diff infections
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