Toxic megacolon

As toxic megacolon is a rare but life-threatening complication, especially in patients with ulcerative colitis is, since they quickly progressing ( fulminant ) to acute dilation ( dilation ) of the large intestine leads (→ megacolon ) and is characterized by inflammation and a septic- toxic state form. Also, Chagas disease, Crohn's disease or pseudomembranous colitis can lead to toxic megacolon.

Symptoms

Symptoms include, in addition to a painful swollen acute abdomen:

• Ileus
• Shock
• High fever (septic temperature)
• Highly elevated erythrocyte sedimentation rate
• Tachycardia
• Anemia
• Disturbances in the water - electrolyte balance

Diagnostics

The diagnosis is made by X-ray ( plain abdominal → ).

Therapy

The toxic megacolon is conservative difficult to control, so that the therapy is usually done surgically. It is a relief of the intestine, primarily by means of a system ileostomy, sought. Alternatively, a surgical fistula of the transverse colon from the sigmoid in question. Especially in ulcerative colitis is a radical operation (→ proctocolectomy with ileoanal pouch anastomosis ) drug of choice.

Histology

Due to the autoreactive response of the immigrant granulocytes, the mucosa and submucosa on multiple ulcers. This results mainly connective tissue necrosis, which can lead to dilatation and perforation of the colon.