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{{Toxic megacolon}}
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==Overview==
Patients with toxic megacolon usually appear ill. Physical examination of patients with toxic megacolon is usually remarkable for [[abdominal pain]], [[rebound tenderness]] and [[guarding]], [[hypotension]] and [[tachycardia]].
 
==Physical Examination==
==Physical Examination==
Patients with toxic megacolon usually appear ill and [[dehydrated]]. [[Physical examination]] of patients with toxic megacolon is usually remarkable for [[abdominal pain]] and [[tenderness]], [[Abdominal distension|abdominal distention]], [[decreased bowel sounds]].<ref name="GanBeck2003">{{cite journal|last1=Gan|first1=S. Ian|last2=Beck|first2=P. L.|title=A new look at toxic megacolon: an update and review of incidence, etiology, pathogenesis, and management|journal=The American Journal of Gastroenterology|volume=98|issue=11|year=2003|pages=2363–2371|issn=0002-9270|doi=10.1111/j.1572-0241.2003.07696.x}}</ref><ref name="pmid5305933">{{cite journal |vauthors=Jalan KN, Sircus W, Card WI, Falconer CW, Bruce CB, Crean GP, McManus JP, Small WP, Smith AN |title=An experience of ulcerative colitis. I. Toxic dilation in 55 cases |journal=Gastroenterology |volume=57 |issue=1 |pages=68–82 |year=1969 |pmid=5305933 |doi= |url=}}</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="Sayedy2010">{{cite journal|last1=Sayedy|first1=Leena|title=Toxic megacolon associatedClostridium difficilecolitis|journal=World Journal of Gastrointestinal Endoscopy|volume=2|issue=8|year=2010|pages=293|issn=1948-5190|doi=10.4253/wjge.v2.i8.293}}</ref><ref name="pmid24765512">{{cite journal |vauthors=Hefaiedh R, Cheikh M, Ennaifer R, Gharbi L, Hadj NB |title=Toxic megacolon complicating a first course of Crohn's disease: about two cases |journal=Clin Pract |volume=3 |issue=2 |pages=e24 |year=2013 |pmid=24765512 |pmc=3981266 |doi=10.4081/cp.2013.e24 |url=}}</ref>
===Appearance of the Patient===
*Patients with toxic megacolon usually appear ill.<ref name="pmid14122466">{{cite journal |vauthors=SILVERBERG D, ROGERS AG |title=TOXIC MEGACOLON IN ULCERATIVE COLITIS |journal=Can Med Assoc J |volume=90 |issue= |pages=357–63 |year=1964 |pmid=14122466 |pmc=1922240 |doi= |url=}}</ref>
===Vital Signs===
===Vital Signs===
====Pulse====
 
=====Rate=====
*High-grade [[fever]] (usually temperature >101.5°F (38.6°C)
*[[Tachycardia]] may be present
*[[Tachycardia]] with regular pulse ( usually [[heart rate]] >120 beats/min)
====Blood Pressure====
*Low [[blood pressure]] with normal [[pulse pressure]]
*[[Hypotension]] may be present
 
===Skin===
* [[Pallor]]
 
===Abdomen===
===Abdomen===
*[[Abdominal distention]] may be present
Abdominal examination may reveal signs of [[peritoneal]] irritation including:<ref name="pmid5305933">{{cite journal |vauthors=Jalan KN, Sircus W, Card WI, Falconer CW, Bruce CB, Crean GP, McManus JP, Small WP, Smith AN |title=An experience of ulcerative colitis. I. Toxic dilation in 55 cases |journal=Gastroenterology |volume=57 |issue=1 |pages=68–82 |year=1969 |pmid=5305933 |doi= |url=}}</ref><ref name="pmid14122466">{{cite journal |vauthors=SILVERBERG D, ROGERS AG |title=TOXIC MEGACOLON IN ULCERATIVE COLITIS |journal=Can Med Assoc J |volume=90 |issue= |pages=357–63 |year=1964 |pmid=14122466 |pmc=1922240 |doi= |url=}}</ref>
*[[Abdominal tenderness]] may be present
*[[Abdominal distention]]  
*Possible loss of bowel sounds
*[[Abdominal rebound tenderness]]
*[[Abdominal guarding]]
*Abdominal rigidity
 
===Neuromuscular===
* [[Altered mental status]]


==References==
==References==
{{reflist|2}}
{{Reflist|2}}
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Latest revision as of 20:38, 20 November 2017

Toxic Megacolon Microchapters

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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

Patients with toxic megacolon usually appear ill. Physical examination of patients with toxic megacolon is usually remarkable for abdominal pain, rebound tenderness and guarding, hypotension and tachycardia.

Physical Examination

Patients with toxic megacolon usually appear ill and dehydrated. Physical examination of patients with toxic megacolon is usually remarkable for abdominal pain and tenderness, abdominal distention, decreased bowel sounds.[1][2][3][4][5]

Appearance of the Patient

  • Patients with toxic megacolon usually appear ill.[6]

Vital Signs

Skin

Abdomen

Abdominal examination may reveal signs of peritoneal irritation including:[2][6]

Neuromuscular

References

  1. ↑ Gan, S. Ian; Beck, P. L. (2003). "A new look at toxic megacolon: an update and review of incidence, etiology, pathogenesis, and management". The American Journal of Gastroenterology. 98 (11): 2363–2371. doi:10.1111/j.1572-0241.2003.07696.x. ISSN 0002-9270.
  2. ↑ 2.0 2.1 Jalan KN, Sircus W, Card WI, Falconer CW, Bruce CB, Crean GP, McManus JP, Small WP, Smith AN (1969). "An experience of ulcerative colitis. I. Toxic dilation in 55 cases". Gastroenterology. 57 (1): 68–82. PMID 5305933.
  3. ↑ 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.
  4. ↑ Sayedy, Leena (2010). "Toxic megacolon associatedClostridium difficilecolitis". World Journal of Gastrointestinal Endoscopy. 2 (8): 293. doi:10.4253/wjge.v2.i8.293. ISSN 1948-5190.
  5. ↑ Hefaiedh R, Cheikh M, Ennaifer R, Gharbi L, Hadj NB (2013). "Toxic megacolon complicating a first course of Crohn's disease: about two cases". Clin Pract. 3 (2): e24. doi:10.4081/cp.2013.e24. PMC 3981266. PMID 24765512.
  6. ↑ 6.0 6.1 SILVERBERG D, ROGERS AG (1964). "TOXIC MEGACOLON IN ULCERATIVE COLITIS". Can Med Assoc J. 90: 357–63. PMC 1922240. PMID 14122466.

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