Toxic megacolon laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
Laboratory findings consistent with the diagnosis of toxic megacolon include anemia and leukocytosis. Some patients with toxic megacolon may have elevated concentration of ESR and CRP, which is usually suggestive of | Laboratory findings consistent with the diagnosis of toxic megacolon include [[anemia]] and [[leukocytosis]]. Some patients with toxic megacolon may have elevated [[Concentrations|concentration]] of [[Erythrocyte sedimentation rate|Erythrocyte sedimentation rate (ESR)]] and [[C-reactive protein (CRP)]], which is usually suggestive of [[inflammation]]. | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
*Laboratory findings consistent with the diagnosis of toxic megacolon include:<ref name="pmid24163654">{{cite journal |vauthors=Antonopoulos P, Almyroudi M, Kolonia V, Kouris S, Troumpoukis N, Economou N |title=Toxic Megacolon and Acute Ischemia of the Colon due to Sigmoid Stenosis Related to Diverticulitis |journal=Case Rep Gastroenterol |volume=7 |issue=3 |pages=409–13 |year=2013 |pmid=24163654 |pmc=3806696 |doi=10.1159/000355345 |url=}}</ref> | *Laboratory findings consistent with the diagnosis of toxic megacolon include:<ref name="pmid24163654">{{cite journal |vauthors=Antonopoulos P, Almyroudi M, Kolonia V, Kouris S, Troumpoukis N, Economou N |title=Toxic Megacolon and Acute Ischemia of the Colon due to Sigmoid Stenosis Related to Diverticulitis |journal=Case Rep Gastroenterol |volume=7 |issue=3 |pages=409–13 |year=2013 |pmid=24163654 |pmc=3806696 |doi=10.1159/000355345 |url=}}</ref><ref name="pmid12067">{{cite journal |vauthors=Caprilli R, Vernia P, Colaneri O, Torsoli A |title=Blood pH: a test for assessment of severity in proctocolitis |journal=Gut |volume=17 |issue=10 |pages=763–9 |year=1976 |pmid=12067 |pmc=1411181 |doi= |url=}}</ref><ref name="pmid9737284">{{cite journal |vauthors=Kuroki K, Masuda A, Uehara H, Kuroki A |title=A new treatment for toxic megacolon |journal=Lancet |volume=352 |issue=9130 |pages=782 |year=1998 |pmid=9737284 |doi= |url=}}</ref><ref name="Strong2010">{{cite journal|last1=Strong|first1=Scott|title=Management of Acute Colitis and Toxic Megacolon|journal=Clinics in Colon and Rectal Surgery|volume=23|issue=04|year=2010|pages=274–284|issn=1531-0043|doi=10.1055/s-0030-1268254}}</ref><ref name="pmid22009735">{{cite journal |vauthors=Autenrieth DM, Baumgart DC |title=Toxic megacolon |journal=Inflamm. Bowel Dis. |volume=18 |issue=3 |pages=584–91 |year=2012 |pmid=22009735 |doi=10.1002/ibd.21847 |url=}}</ref> | ||
**[[Anemia]] | **[[Anemia]] | ||
**[[Leukocytosis]] | **[[Leukocytosis]] especially in patients with [[Clostridium difficile infection|''Clostridium difficile'' infection]] | ||
*Some patients with toxic megacolon may have elevated Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) concentration.<ref name="BrownHaboubi2008">{{cite journal|last1=Brown|first1=S. R.|last2=Haboubi|first2=N.|last3=Hampton|first3=J.|last4=George|first4=B.|last5=Travis|first5=S. P. L.|title=The Management of Acute Severe Colitis: ACPGBI Position Statement|journal=Colorectal Disease|volume=10|year=2008|pages=8–29|issn=14628910|doi=10.1111/j.1463-1318.2008.01682.x}}</ref><ref name="pmid22131898">{{cite journal |vauthors=Strong SA |title=Management of acute colitis and toxic megacolon |journal=Clin Colon Rectal Surg |volume=23 |issue=4 |pages=274–84 |year=2010 |pmid=22131898 |pmc=3134807 |doi=10.1055/s-0030-1268254 |url=}}</ref><ref name="OrabonaValcamonico2015">{{cite journal|last1=Orabona|first1=Rossana|last2=Valcamonico|first2=Adriana|last3=Salemme|first3=Marianna|last4=Manenti|first4=Stefania|last5=Tiberio|first5=Guido AM|last6=Frusca|first6=Tiziana|title=Fulminant ulcerative colitis in a healthy pregnant woman|journal=World Journal of Gastroenterology|volume=21|issue=19|year=2015|pages=6060–6064|issn=1007-9327|doi=10.3748/wjg.v21.i19.6060}}</ref> | **[[Hypoalbuminemia]] | ||
*Electrolyte disturbances are common secondary to inflammatory diarrhea, steroid use and ongoing gastrointestinal losses.<ref name="pmid8282262">{{cite journal |vauthors=Panos MZ, Wood MJ, Asquith P |title=Toxic megacolon: the knee-elbow position relieves bowel distension |journal=Gut |volume=34 |issue=12 |pages=1726–7 |year=1993 |pmid=8282262 |pmc=1374472 |doi= |url=}}</ref><ref name="pmid9482465">{{cite journal |vauthors=Sheth SG, LaMont JT |title=Toxic megacolon |journal=Lancet |volume=351 |issue=9101 |pages=509–13 |year=1998 |pmid=9482465 |doi=10.1016/S0140-6736(97)10475-5 |url=}}</ref><ref | **[[Metabolic alkalosis]] associated with a poor [[prognosis]] | ||
**[[Metabolic acidosis]] secondary to [[ischemic colitis]] | |||
*Some patients with toxic megacolon may have elevated [[Erythrocyte sedimentation rate|Erythrocyte sedimentation rate (ESR)]] and [[C-reactive protein (CRP)]] concentration.<ref name="BrownHaboubi2008">{{cite journal|last1=Brown|first1=S. R.|last2=Haboubi|first2=N.|last3=Hampton|first3=J.|last4=George|first4=B.|last5=Travis|first5=S. P. L.|title=The Management of Acute Severe Colitis: ACPGBI Position Statement|journal=Colorectal Disease|volume=10|year=2008|pages=8–29|issn=14628910|doi=10.1111/j.1463-1318.2008.01682.x}}</ref><ref name="pmid22131898">{{cite journal |vauthors=Strong SA |title=Management of acute colitis and toxic megacolon |journal=Clin Colon Rectal Surg |volume=23 |issue=4 |pages=274–84 |year=2010 |pmid=22131898 |pmc=3134807 |doi=10.1055/s-0030-1268254 |url=}}</ref><ref name="OrabonaValcamonico2015">{{cite journal|last1=Orabona|first1=Rossana|last2=Valcamonico|first2=Adriana|last3=Salemme|first3=Marianna|last4=Manenti|first4=Stefania|last5=Tiberio|first5=Guido AM|last6=Frusca|first6=Tiziana|title=Fulminant ulcerative colitis in a healthy pregnant woman|journal=World Journal of Gastroenterology|volume=21|issue=19|year=2015|pages=6060–6064|issn=1007-9327|doi=10.3748/wjg.v21.i19.6060}}</ref><ref name="pmid11144376">{{cite journal |vauthors=Chao HC, Chiu CH, Kong MS, Chang LY, Huang YC, Lin TY, Lou CC |title=Factors associated with intestinal perforation in children's non-typhi Salmonella toxic megacolon |journal=Pediatr. Infect. Dis. J. |volume=19 |issue=12 |pages=1158–62 |year=2000 |pmid=11144376 |doi= |url=}}</ref> | |||
*[[Electrolyte disturbances]] are common secondary to [[inflammatory]] [[diarrhea]], [[steroid]] use and ongoing gastrointestinal losses.<ref name="Strong2010">{{cite journal|last1=Strong|first1=Scott|title=Management of Acute Colitis and Toxic Megacolon|journal=Clinics in Colon and Rectal Surgery|volume=23|issue=04|year=2010|pages=274–284|issn=1531-0043|doi=10.1055/s-0030-1268254}}</ref><ref name="pmid8282262">{{cite journal |vauthors=Panos MZ, Wood MJ, Asquith P |title=Toxic megacolon: the knee-elbow position relieves bowel distension |journal=Gut |volume=34 |issue=12 |pages=1726–7 |year=1993 |pmid=8282262 |pmc=1374472 |doi= |url=}}</ref><ref name="pmid9482465">{{cite journal |vauthors=Sheth SG, LaMont JT |title=Toxic megacolon |journal=Lancet |volume=351 |issue=9101 |pages=509–13 |year=1998 |pmid=9482465 |doi=10.1016/S0140-6736(97)10475-5 |url=}}</ref><ref><nowiki>{cite book | last = Koyfman | first = Alex | title = Emergency medicine images for practice : an overview of X-ray, ultrasound, CT, and MRI images | publisher = Wolters Kluwer | location = Philadelphia | year = 2016 | isbn = 9781451192209 }}</nowiki></ref> | |||
==References== | ==References== |
Latest revision as of 15:42, 28 November 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]
Overview
Laboratory findings consistent with the diagnosis of toxic megacolon include anemia and leukocytosis. Some patients with toxic megacolon may have elevated concentration of Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), which is usually suggestive of inflammation.
Laboratory Findings
- Laboratory findings consistent with the diagnosis of toxic megacolon include:[1][2][3][4][5]
- Anemia
- Leukocytosis especially in patients with Clostridium difficile infection
- Hypoalbuminemia
- Metabolic alkalosis associated with a poor prognosis
- Metabolic acidosis secondary to ischemic colitis
- Some patients with toxic megacolon may have elevated Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) concentration.[6][7][8][9]
- Electrolyte disturbances are common secondary to inflammatory diarrhea, steroid use and ongoing gastrointestinal losses.[4][10][11][12]
References
- ↑ Antonopoulos P, Almyroudi M, Kolonia V, Kouris S, Troumpoukis N, Economou N (2013). "Toxic Megacolon and Acute Ischemia of the Colon due to Sigmoid Stenosis Related to Diverticulitis". Case Rep Gastroenterol. 7 (3): 409–13. doi:10.1159/000355345. PMC 3806696. PMID 24163654.
- ↑ Caprilli R, Vernia P, Colaneri O, Torsoli A (1976). "Blood pH: a test for assessment of severity in proctocolitis". Gut. 17 (10): 763–9. PMC 1411181. PMID 12067.
- ↑ Kuroki K, Masuda A, Uehara H, Kuroki A (1998). "A new treatment for toxic megacolon". Lancet. 352 (9130): 782. PMID 9737284.
- ↑ 4.0 4.1 Strong, Scott (2010). "Management of Acute Colitis and Toxic Megacolon". Clinics in Colon and Rectal Surgery. 23 (04): 274–284. doi:10.1055/s-0030-1268254. ISSN 1531-0043.
- ↑ Autenrieth DM, Baumgart DC (2012). "Toxic megacolon". Inflamm. Bowel Dis. 18 (3): 584–91. doi:10.1002/ibd.21847. PMID 22009735.
- ↑ Brown, S. R.; Haboubi, N.; Hampton, J.; George, B.; Travis, S. P. L. (2008). "The Management of Acute Severe Colitis: ACPGBI Position Statement". Colorectal Disease. 10: 8–29. doi:10.1111/j.1463-1318.2008.01682.x. ISSN 1462-8910.
- ↑ Strong SA (2010). "Management of acute colitis and toxic megacolon". Clin Colon Rectal Surg. 23 (4): 274–84. doi:10.1055/s-0030-1268254. PMC 3134807. PMID 22131898.
- ↑ Orabona, Rossana; Valcamonico, Adriana; Salemme, Marianna; Manenti, Stefania; Tiberio, Guido AM; Frusca, Tiziana (2015). "Fulminant ulcerative colitis in a healthy pregnant woman". World Journal of Gastroenterology. 21 (19): 6060–6064. doi:10.3748/wjg.v21.i19.6060. ISSN 1007-9327.
- ↑ Chao HC, Chiu CH, Kong MS, Chang LY, Huang YC, Lin TY, Lou CC (2000). "Factors associated with intestinal perforation in children's non-typhi Salmonella toxic megacolon". Pediatr. Infect. Dis. J. 19 (12): 1158–62. PMID 11144376.
- ↑ Panos MZ, Wood MJ, Asquith P (1993). "Toxic megacolon: the knee-elbow position relieves bowel distension". Gut. 34 (12): 1726–7. PMC 1374472. PMID 8282262.
- ↑ Sheth SG, LaMont JT (1998). "Toxic megacolon". Lancet. 351 (9101): 509–13. doi:10.1016/S0140-6736(97)10475-5. PMID 9482465.
- ↑ {cite book | last = Koyfman | first = Alex | title = Emergency medicine images for practice : an overview of X-ray, ultrasound, CT, and MRI images | publisher = Wolters Kluwer | location = Philadelphia | year = 2016 | isbn = 9781451192209 }}