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Toxic megacolon

MedGen UID:
9940
•Concept ID:
C0025162
•
Disease or Syndrome
Synonyms: Megacolon, Toxic; Toxic Megacolon
SNOMED CT: Toxic megacolon (1269214001); Toxic state due to colonic dilatation (1269214001)
 
Monarch Initiative: MONDO:0002105

Definition

An acute form of megacolon, severe pathological dilatation of the colon. It is associated with clinical conditions such as ulcerative colitis; crohn disease; amebic dysentery; or clostridium enterocolitis. [from MONDO]

Professional guidelines

PubMed

Approach to the patient with infectious colitis: clinical features, work-up and treatment.
Iqbal T, DuPont HL
Curr Opin Gastroenterol 2021 Jan;37(1):66-75. doi: 10.1097/MOG.0000000000000693. PMID: 33105253
Clostridioides difficile Infection: Update on Management.
Mounsey A, Lacy Smith K, Reddy VC, Nickolich S
Am Fam Physician 2020 Feb 1;101(3):168-175. PMID: 32003951
Consensus on the prevention, diagnosis, and treatment of Clostridium difficile infection.
Abreu Y Abreu AT, Velarde-Ruiz Velasco JA, Zavala-Solares MR, Remes-Troche JM, Carmona-Sánchez RI, Aldana-Ledesma JM, Camacho-Ortiz A, Contreras-Omaña R, Díaz-Seoane R, Elizondo-Vázquez CT, Garza-González E, Grajales-Figueroa G, Gómez-Escudero O, Jacobo-Karam JS, Morales-Arámbula M, Olivares-Guzmán LO, Sifuentes-Osornio J, Siu-Moguel AG, Soto-Solís R, Valdovinos-García LR, Valdovinos-Díaz MA, Vázquez-Elizondo G, Lazo-de la Vega Jasso SA
Rev Gastroenterol Mex (Engl Ed) 2019 Apr-Jun;84(2):204-219. Epub 2019 Apr 12 doi: 10.1016/j.rgmx.2018.12.001. PMID: 30987771

Recent clinical studies

Etiology

A Review of Clostridioides difficile Infection and Antibiotic-Associated Diarrhea.
Abad CLR, Safdar N
Gastroenterol Clin North Am 2021 Jun;50(2):323-340. doi: 10.1016/j.gtc.2021.02.010. PMID: 34024444
Clostridioides difficile Infection: Update on Management.
Mounsey A, Lacy Smith K, Reddy VC, Nickolich S
Am Fam Physician 2020 Feb 1;101(3):168-175. PMID: 32003951
A comprehensive review and update on ulcerative colitis().
Gajendran M, Loganathan P, Jimenez G, Catinella AP, Ng N, Umapathy C, Ziade N, Hashash JG
Dis Mon 2019 Dec;65(12):100851. Epub 2019 Mar 2 doi: 10.1016/j.disamonth.2019.02.004. PMID: 30837080
Acute colonic pseudo-obstruction.
Saunders MD
Best Pract Res Clin Gastroenterol 2007;21(4):671-87. doi: 10.1016/j.bpg.2007.03.001. PMID: 17643908
Clostridium difficile.
Settle CD
Br J Hosp Med 1996 Oct 16-Nov 5;56(8):398-400. PMID: 8909713

Diagnosis

A Review of Clostridioides difficile Infection and Antibiotic-Associated Diarrhea.
Abad CLR, Safdar N
Gastroenterol Clin North Am 2021 Jun;50(2):323-340. doi: 10.1016/j.gtc.2021.02.010. PMID: 34024444
Clostridioides difficile Infection: Update on Management.
Mounsey A, Lacy Smith K, Reddy VC, Nickolich S
Am Fam Physician 2020 Feb 1;101(3):168-175. PMID: 32003951
A comprehensive review and update on ulcerative colitis().
Gajendran M, Loganathan P, Jimenez G, Catinella AP, Ng N, Umapathy C, Ziade N, Hashash JG
Dis Mon 2019 Dec;65(12):100851. Epub 2019 Mar 2 doi: 10.1016/j.disamonth.2019.02.004. PMID: 30837080
Clostridium difficile infection and antibiotic-associated diarrhoea.
Mullish BH, Williams HR
Clin Med (Lond) 2018 Jun;18(3):237-241. doi: 10.7861/clinmedicine.18-3-237. PMID: 29858434Free PMC Article
Clostridium difficile infection: epidemiology, diagnosis and understanding transmission.
Martin JS, Monaghan TM, Wilcox MH
Nat Rev Gastroenterol Hepatol 2016 Apr;13(4):206-16. Epub 2016 Mar 9 doi: 10.1038/nrgastro.2016.25. PMID: 26956066

Therapy

A Review of Clostridioides difficile Infection and Antibiotic-Associated Diarrhea.
Abad CLR, Safdar N
Gastroenterol Clin North Am 2021 Jun;50(2):323-340. doi: 10.1016/j.gtc.2021.02.010. PMID: 34024444
Approach to the patient with infectious colitis: clinical features, work-up and treatment.
Iqbal T, DuPont HL
Curr Opin Gastroenterol 2021 Jan;37(1):66-75. doi: 10.1097/MOG.0000000000000693. PMID: 33105253
Clostridioides difficile Infection: Update on Management.
Mounsey A, Lacy Smith K, Reddy VC, Nickolich S
Am Fam Physician 2020 Feb 1;101(3):168-175. PMID: 32003951
A comprehensive review and update on ulcerative colitis().
Gajendran M, Loganathan P, Jimenez G, Catinella AP, Ng N, Umapathy C, Ziade N, Hashash JG
Dis Mon 2019 Dec;65(12):100851. Epub 2019 Mar 2 doi: 10.1016/j.disamonth.2019.02.004. PMID: 30837080
Clostridium difficile infection and antibiotic-associated diarrhoea.
Mullish BH, Williams HR
Clin Med (Lond) 2018 Jun;18(3):237-241. doi: 10.7861/clinmedicine.18-3-237. PMID: 29858434Free PMC Article

Prognosis

A comprehensive review and update on ulcerative colitis().
Gajendran M, Loganathan P, Jimenez G, Catinella AP, Ng N, Umapathy C, Ziade N, Hashash JG
Dis Mon 2019 Dec;65(12):100851. Epub 2019 Mar 2 doi: 10.1016/j.disamonth.2019.02.004. PMID: 30837080
Clostridium difficile infection.
Alcalá Hernández L, Reigadas Ramírez E, Bouza Santiago E
Med Clin (Barc) 2017 May 23;148(10):456-463. Epub 2017 Apr 8 doi: 10.1016/j.medcli.2017.01.033. PMID: 28396132
Clostridium difficile-associated colitis.
Hull MW, Beck PL
Can Fam Physician 2004 Nov;50:1536-40, 1543-5. PMID: 15597970Free PMC Article
Toxic megacolon.
Sheth SG, LaMont JT
Lancet 1998 Feb 14;351(9101):509-13. doi: 10.1016/S0140-6736(97)10475-5. PMID: 9482465
Toxic megacolon.
Present DH
Med Clin North Am 1993 Sep;77(5):1129-48. doi: 10.1016/s0025-7125(16)30214-0. PMID: 8371619

Clinical prediction guides

The Gut Bacterial Community Potentiates Clostridioides difficile Infection Severity.
Lesniak NA, Schubert AM, Flynn KJ, Leslie JL, Sinani H, Bergin IL, Young VB, Schloss PD
mBio 2022 Aug 30;13(4):e0118322. Epub 2022 Jul 20 doi: 10.1128/mbio.01183-22. PMID: 35856563Free PMC Article
The prognostic value of toxin B and binary toxin in Clostridioides difficile infection.
López-Cárdenas S, Torres-Martos E, Mora-Delgado J, Sánchez-Calvo JM, Santos-Peña M, Zapata López Á, Dolores López-Prieto M, Pérez-Cortés S, Carlos Alados J
Gut Microbes 2021 Jan-Dec;13(1):1884516. Epub 2021 Mar 4 doi: 10.1080/19490976.2021.1884516. PMID: 33660568Free PMC Article
A comprehensive review and update on ulcerative colitis().
Gajendran M, Loganathan P, Jimenez G, Catinella AP, Ng N, Umapathy C, Ziade N, Hashash JG
Dis Mon 2019 Dec;65(12):100851. Epub 2019 Mar 2 doi: 10.1016/j.disamonth.2019.02.004. PMID: 30837080
Surgical Management of Toxic Megacolon.
Tapani MJ, Olavi KH
Hepatogastroenterology 2014 May;61(131):638-41. PMID: 26176049
Clostridium difficile-associated colitis.
Hull MW, Beck PL
Can Fam Physician 2004 Nov;50:1536-40, 1543-5. PMID: 15597970Free PMC Article

Recent systematic reviews

Diagnosis and Management of Cuffitis: A Systematic Review.
Hembree AE, Scherl E
Dis Colon Rectum 2022 Dec 1;65(S1):S85-S91. Epub 2022 Aug 25 doi: 10.1097/DCR.0000000000002593. PMID: 36399769
CT features of toxic megacolon: A systematic review.
Eghbali E, Akhavi Milani A, Shirmohamadi M, Hosseinifard H
Radiography (Lond) 2021 May;27(2):716-720. Epub 2020 Nov 12 doi: 10.1016/j.radi.2020.10.019. PMID: 33189537
Secretory diarrhea and hypokalemia associated with colonic pseudo-obstruction: A case study and systematic analysis of the literature.
Bazerbachi F, Haffar S, Szarka LA, Wang Z, Prokop LJ, Murad MH, Camilleri M
Neurogastroenterol Motil 2017 Nov;29(11) Epub 2017 Jun 5 doi: 10.1111/nmo.13120. PMID: 28580600
Antioxidant therapy for treatment of inflammatory bowel disease: Does it work?
Moura FA, de Andrade KQ, Dos Santos JCF, Araújo ORP, Goulart MOF
Redox Biol 2015 Dec;6:617-639. Epub 2015 Oct 23 doi: 10.1016/j.redox.2015.10.006. PMID: 26520808Free PMC Article
Clostridium difficile: epidemiology, diagnostic and therapeutic possibilities-a systematic review.
Kazanowski M, Smolarek S, Kinnarney F, Grzebieniak Z
Tech Coloproctol 2014 Mar;18(3):223-32. Epub 2013 Nov 1 doi: 10.1007/s10151-013-1081-0. PMID: 24178946Free PMC Article

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