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World J Emerg Surg 2021 May 11;16(1):23. Epub 2021 May 11.

Department of Surgical Sciences, Policlinico Sant'Orsola Malpighi, Bologna, Italy.

Background: Despite the current therapeutic options for the treatment of inflammatory bowel disease, surgery is still frequently required in the emergency setting, although the number of cases performed seems to have decreased in recent years. The World Society of Emergency Surgery decided to debate in a consensus conference of experts, the main pertinent issues around the management of inflammatory bowel disease in the emergent situation, with the need to provide focused guidelines for acute care and emergency surgeons.

Method: A group of experienced surgeons and gastroenterologists were nominated to develop the topics assigned and answer the questions addressed by the Steering Committee of the project. Read More

World J Clin Cases 2021 May;9(13):3219-3226

Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu 18618687, São Paulo, Brazil.

Background: Acute severe ulcerative colitis (ASUC) is a complication of ulcerative colitis associated with high levels of circulating tumor necrosis factor alpha, due to the intense inflammation and faster stool clearance of anti-tumor necrosis factor drugs. Dose-intensified infliximab treatment can be beneficial and is associated with lower rates of colectomy. The aim of the study was to present a case of a patient with ASUC and megacolon, treated with hydrocortisone and accelerated scheme of infliximab that was monitored by drug trough level. Read More

Medicine (Baltimore) 2021 May;100(18):e25772

Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.

Rationale: Gastrointestinal tract duplication is a rare congenial anomaly which can be found anywhere along the gastrointestinal tract. While many patients are incidentally diagnosed during operation, in some cases it can present with severe gastrointestinal symptoms. In this case report, the patient presented with signs of toxic megacolon leading to rapid aggravation of inflammatory shock. Read More

BMC Surg 2021 Mar 3;21(1):109. Epub 2021 Mar 3.

Department of Surgery, Tikur Anbessa Specialized Hospital, Addis Ababa University, Zambia St., Addis Ababa, Ethiopia.

Background: Sigmoid volvulus is an uncommon problem in children and adolescents, and is rarely considered a diagnosis in this group. A high index of suspicion is necessary to reach a diagnosis and avoid morbidity and mortality. Sigmoid volvulus is a rare complication of Hirschsprung's disease, which has been reported in neonates, children, and adults. Read More

Chirurg 2021 Jun 25;92(6):551-558. Epub 2021 Feb 25.

Abteilung für Allgemein und Viszeralchirurgie, BG Klinikum Hamburg, Hamburg, Deutschland.

Background: Patients with paraplegia develop syndrome-specific complications relevant to visceral surgery, which occur in the context of the acute spinal shock or as a consequence of the progressive neurogenic bowel dysfunction (NBD) with the formation of an elongated colon and/or megacolon. Moreover, acute abdominal emergencies, such as acute appendicitis, cholecystitis, diverticulitis and ileus images, pose particular challenges for the clinician when the clinical signs are atypical or even absent. The expansion of indications for obesity surgery to include patients with a paraplegic syndrome, whose independence and quality of life can be impaired due to the restricted mobility, especially by obesity, is becoming increasingly more important. Read More

ANZ J Surg 2021 01;91(1-2):214

Department of Community and Family Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.

PLoS One 2021 9;16(2):e0246692. Epub 2021 Feb 9.

Department of Bioscience and Technology, Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiania, GO, Brazil.

Megacolon is one of the main late complications of Chagas disease, affecting approximately 10% of symptomatic patients. However, studies are needed to understand the mechanisms involved in the progression of this condition. During infection by Trypanosoma cruzi (T. Read More

BMJ Case Rep 2020 Dec 22;13(12). Epub 2020 Dec 22.

General Surgery, Dudley Group NHS Foundation Trust, Dudley, UK

Cholecystocolonic fistula with associated idiopathic megabowel (megacolon and megarectum) is a rare presentation as acute large bowel obstruction. Frequently presenting with chronic constipation, acute bowel obstruction is rarely encountered in the presence of concomitant cholecystocolonic fistula. This presents diagnostic and management difficulties with no consensus on appropriate surgical approach. Read More

Front Cell Infect Microbiol 2020 15;10:583899. Epub 2020 Oct 15.

Departament of Pathology, Federal University of Minas Gerais, Belo Horizonte, Brazil.

There is a growing consensus that the balance between the persistence of infection and the host immune response is crucial for chronification of Chagas heart disease. Extrapolation for chagasic megacolon is hampered because research in humans and animal models that reproduce intestinal pathology is lacking. The parasite-host relationship and its consequence to the disease are not well-known. Read More

Curr Opin Gastroenterol 2021 Jan;37(1):66-75

University of Texas School of Public Health.

Purpose Of Review: To provide the definition, causes, and current recommendations for workup and treatment of acute infectious colitis in adults, a common medical problem of diverse cause.

Recent Findings: The management of acute colitis in adults depend upon establishment of cause. Most forms of infectious colitis are treatable with antimicrobials. Read More

Curr Opin Crit Care 2020 12;26(6):648-657

Department of Critical Care Medicine, University of British Columbia, Vancouver, British Columbia.

Purpose Of Review: The aim of this study was to describe important features of clinical examination for the surgical abdomen, relevant investigations, and acute management of common surgical problems in the critically ill.

Recent Findings: Lactate remains a relatively nonspecific marker of gut ischemia. Dual energy computed tomography (DECT) scan can improve diagnosis of bowel ischemia. Read More

Anesth Prog 2020 09;67(3):158-163

Department of Anesthesiology, Kanagawa Dental University Hospital, Yokosuka, Kanagawa, Japan.

Inflammatory bowel disease (IBD) is a group of chronic inflammatory disorders of the gastrointestinal tract including ulcerative colitis (UC) and Crohn's disease. Pain management can be challenging in patients with IBD because there are limitations on the use of analgesics. Use of nonsteroidal anti-inflammatory drugs is not recommended in patients with IBD because there is risk of relapse of IBD and an overall increase in disease activity. Read More

Ann R Coll Surg Engl 2020 Sep 17;102(7):e176-e179. Epub 2020 Aug 17.

Department of General and Digestive Surgery, University Hospital of Móstoles, Madrid, Spain.

Spain has been one of the most affected countries by the COVID-19 outbreak. After the high impact of the pandemic, a wide clinical spectrum of late complications associated with COVID-19 are being observed. We report a case of a severe colitis in a post-treatment and recovered COVID-19 patient. Read More

Sci Adv 2020 Jul 22;6(30):eaaz2015. Epub 2020 Jul 22.

Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK 73019, USA.

Chagas disease (CD) is a parasitic disease caused by protozoa, presenting with cardiomyopathy, megaesophagus, and/or megacolon. To determine the mechanisms of gastrointestinal (GI) CD tissue tropism, we systematically characterized the spatial localization of infection-induced metabolic and microbiome alterations, in a mouse model of CD. Notably, the impact of the transition between acute and persistent infection differed between tissue sites, with sustained large-scale effects of infection in the esophagus and large intestine, providing a potential mechanism for the tropism of CD within the GI tract. Read More

Surg Today 2021 Feb 23;51(2):181-186. Epub 2020 Jun 23.

Department of Pediatric Surgery, Graduate School of Medical Sciences, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

Hirschsprung's disease (HD) is a congenital disease manifesting various degrees of functional bowel obstruction caused by the absence of enteric ganglion cells, which are usually absent in the colonic segment of the HD patient. Because the aganglionic segment of HD always includes the rectum, pathological diagnosis can be made using a rectal sample. HD should be diagnosed as early as possible because serious complications, such as acute enterocolitis or toxic megacolon, can develop without a definitive diagnosis and appropriate treatment. Read More

Toxins (Basel) 2020 06 8;12(6). Epub 2020 Jun 8.

Department of Medicine, The University of Toledo College of Medicine and Life Sciences, 3000 Arlington Avenue, Toledo, OH 43614, USA.

Harmful algal blooms (HAB) have become a major health concern worldwide, not just to humans that consume and recreate on contaminated waters, but also to the fauna that inhabit the environments surrounding affected areas. HABs contain heterotrophic bacteria, cyanobacterial lipopolysaccharide, and cyanobacterial toxins such as microcystins, that can cause severe toxicity in many aquatic species as well as bioaccumulation within various organs. Thus, the possibility of trophic transference of this toxin through the food chain has potentially important health implications for other organisms in the related food web. Read More

Surg Case Rep 2020 Jun 1;6(1):121. Epub 2020 Jun 1.

Department of General Surgery, Toyohashi Municipal Hospital, 50 Hachiken-nishi, Aotake-cho, Toyohashi, Aichi, 441-8570, Japan.

Background: Ulcerative colitis (UC) developing during chemotherapy is very rare. Here, we describe a case of acute onset during chemoradiotherapy for lung adenocarcinoma, requiring a total proctocolectomy.

Case Presentation: A 52-year-old man was admitted to the hospital for chemoradiotherapy of lung cancer. Read More

Int J Surg Case Rep 2020 11;71:151-154. Epub 2020 May 11.

Department of Pathology, Changi General Hospital, 2 Simei Street 3, S529889, Singapore.

Introduction: Intestinal parasitic infections are a health burden to developing countries, but can also become more prevalent worldwide, even in developed countries, with the advent of globalization. While most of these infections are benign, some may be associated with acute infections with high morbidity and mortality rates.

Case Presentation: A 36 years old patient presented with toxic megacolon with poly-helminthic infections, likely a result of raw food ingestion. Read More

ANZ J Surg 2020 12 12;90(12):E200-E201. Epub 2020 May 12.

Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.

ANZ J Surg 2020 11 8;90(11):2285-2289. Epub 2020 Apr 8.

Department of General Surgery, Daping Hospital, Army Medical University, Chongqing, China.

Background: Idiopathic megacolon (IMC) is an uncommon disease in adults. To date, only a few laparoscopic experiences and functional outcomes of IMC have been reported. This study was to retrospectively analyse our 12 year surgical experience and functional outcomes in adult patients with IMC. Read More

BMJ Case Rep 2020 Mar 22;13(3). Epub 2020 Mar 22.

Department of General Surgery, Borders General Hospital, Melrose, UK.

A 58-year-old woman presented to the emergency department in a district general hospital with severe abdominal pain and diarrhoea, after collapsing at home. She was admitted to the intensive care unit (ICU) in septic shock, and with acute kidney injury. An initial CT scan was suggestive of colitis. Read More

J Pediatr Surg 2020 May 31;55(5):899-903. Epub 2020 Jan 31.

Dewitt-Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL. Electronic address:

Purpose: No nationwide studies on hospital readmissions exist for children who have undergone pull-through operations for Hirschsprung disease. The study aim is to identify determinants of postoperative discharge outcomes and hospital readmissions in children with Hirschsprung disease.

Methods: The Nationwide Readmissions Database for 2010-2014 was queried for children (<18yo) with Hirschsprung disease and whom had undergone pull-through procedure, utilizing ICD-9 codes 751. Read More

J Pediatr Surg 2020 Sep 24;55(9):1829-1833. Epub 2020 Jan 24.

Pediatric Surgery department, Faculty of medicine, Ain Shams University, Egypt.

Background: The outcome in HD has not been always satisfactory even after a technically sound operation.

Purpose: To define the characteristic histopathological features of the pulled-through colon in patients with HD, and it is impact on clinical outcome.

Patients And Methods: The study included patients with HD who underwent surgical repair between 2010 through 2016. Read More

Rev Esp Enferm Dig 2020 Feb;112(2):90-93

Aparato Digestivo, Hospital Universitario Virgen del Rocío, España.

Megacolon is a serious complication of inflammatory bowel disease that often requires a colectomy. Infliximab is a therapeutic alternative when conventional treatment fails, before resorting to surgery. Its use is currently based on the publication of isolated cases. Read More

Anaesthesiol Intensive Ther 2019 ;51(4):273-282

Department of Intensive Care, University Hospital of Brussels (UZB), Jette, Belgium.

Background: Without timely diagnosis, acute primary abdominal compartment syndrome (ACS) is a potentially fatal syndrome and often goes unrecognized until severe symptoms appear. Early diagnosis may significantly improve the prognosis of these patients.

Case Presentation: We present the case of a 54-year-old man, successfully treated for acute myeloid leukemia with cytosine arabinoside, admitted to the intensive care unit with severe shock, refractory to standard therapy with antibiotics, fluid resuscitation, and vasopressors. Read More

Transplant Proc 2019 Nov;51(9):3181-3185

Gastroenterology, Hepatology and Nutrition, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California. Electronic address:

Small intestinal transplantation is performed for patients with intestinal failure who failed other surgical and medical treatment. It carries notable risks, including, but not limited to, acute and chronic cellular rejection and graft malfunction. Late severe acute intestinal allograft rejection is associated with increased risk of morbidity and mortality and, in the majority of cases, ends with total enterectomy. Read More

ANZ J Surg 2020 06 24;90(6):1192-1193. Epub 2019 Oct 24.

Department of Surgery, Queen Elizabeth Hospital, Adelaide, South Australia, Australia.

Exp Ther Med 2019 Oct 5;18(4):2726-2730. Epub 2019 Aug 5.

Colorectal Surgery Department, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310000, P.R. China.

Megacolon is a congenital disorder. Adult congenital megacolon (ACM), also known as adult Hirschsprung's disease, is rare and frequently manifests as constipation. ACM is caused by the absence of ganglion cells in the submucosa or myenteric plexus of the bowel. Read More

J Crohns Colitis 2020 May;14(4):465-479

Department of Gastroenterology, Alfred Hospital and Monash University, Melbourne, Australia.

Background And Aims: Gastrointestinal ultrasound is useful in the assessment of patients with Crohn's disease, but its application in ulcerative colitis [UC] is less well established. Here we systematically review the role of gastrointestinal ultrasound in patients with UC.

Methods: Searches of the PUBMED and EMBASE databases were performed with the following search strategy: [ultrasound OR sonography] AND [intestinal OR bowel] AND [ulcerative colitis OR inflammatory bowel disease]. Read More