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Cureus 2021 Apr 29;13(4):e14751. Epub 2021 Apr 29.

General Surgery, MacDill Air Force Base (AFB), Tampa, USA.

Clostridium difficle (C. diff) is a well known cause of infectious diarrhea across hospitals in the developed world. An anaerobic, gram positive rod bacteria, C. 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

Radiography (Lond) 2021 05 12;27(2):716-720. Epub 2020 Nov 12.

Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Introduction: Toxic megacolon is a rare but life-threatening condition. Diagnosis is made when both systemic toxicity and an enlarged colon are present. We undertook a systematic review of the literature to provide a list of toxic megacolon findings on computed tomography (CT) imaging along with the prevalence rate for each finding. 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

ANZ J Surg 2021 01 11;91(1-2):E40-E42. Epub 2020 Jun 11.

Department of General Surgery, Bunbury Regional Hospital, Bunbury, Western Australia, Australia.

Front Pediatr 2020 20;8:254. Epub 2020 May 20.

Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

infection (cdi) often occurs with long-term and irregular use of antibiotics. Patients with tumors receiving both antibiotics and chemotherapy are at a high risk of cdi. The symptoms of cdi vary but can include diarrhea, hypovolemia, electrolyte imbalance, hypoproteinemia, toxic megacolon, gastrointestinal tract perforation, disseminated intravascular coagulation, sepsis, and other lethal complications. 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

BMJ Case Rep 2019 May 24;12(5). Epub 2019 May 24.

Beaumont Health System, Royal Oak, Michigan, USA.

A female aged 84 years with a history of -associated diarrhoea presented from an extended care facility with altered mental status and respiratory distress. She was haemodynamically unstable and initial laboratory results revealed hyperleucocytosis (110.3×10/L). Read More

J Obstet Gynaecol Res 2019 Jul 7;45(7):1215-1221. Epub 2019 May 7.

Division of Gastroenterology, Department of Internal Medicine and Medical Specialties, "Sapienza" University of Rome, Umberto I Hospital, Rome, Italy.

Ulcerative colitis (UC) is a chronic inflammatory disease rarely arising during gestation. Because the available information is based on case reports or small retrospective studies, diagnosis may be difficult and treatment is still controversial. A case of toxic megacolon developing in late pregnancy associated to a sudden fetal decompensation is described. Read More

Dis Mon 2019 Dec 2;65(12):100851. Epub 2019 Mar 2.

Division of Gastroenterology, American University of Beirut, Beirut, Lebanon; Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh, M2, C Wing, 200 Lothrop Street, Pittsburgh, PA 15213, USA.

Ulcerative colitis (UC) is a chronic idiopathic inflammatory bowel disorder of the colon that causes continuous mucosal inflammation extending from the rectum to the more proximal colon, with variable extents. UC is characterized by a relapsing and remitting course. UC was first described by Samuel Wilks in 1859 and it is more common than Crohn's disease worldwide. Read More

Clin J Gastroenterol 2019 Aug 14;12(4):325-329. Epub 2019 Feb 14.

Third Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.

We report a case of community-acquired fulminant colitis caused by Clostridium difficile in Japan. A 46-year-old woman was diagnosed with severe infectious enterocolitis and was admitted at another hospital. The stool culture was positive for toxigenic C. Read More

BMJ Case Rep 2018 Sep 30;2018. Epub 2018 Sep 30.

Department of Diagnostic Imaging, Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia.

Cureus 2018 May 30;10(5):e2710. Epub 2018 May 30.

Graduate, Pontifical Catholic University of Ecuador, Chagrin Falls, USA.

Crohn's disease (CD) is a granulomatous inflammatory disease that can involve any part of the gastrointestinal tract, from mouth to anus. In most cases, it remits and relapses in the terminal ileum, requiring treatment via steroid boluses. In rare cases, however, CD can involve the pulmonary system presenting as dyspnea on exertion and dry cough. Read More

BMJ Case Rep 2018 Jan 11;2018. Epub 2018 Jan 11.

Department of Intensive Care Unit, Gelderse Vallei Hospital, Ede, The Netherlands.

Z Gastroenterol 2017 Dec 6;55(12):1499-1508. Epub 2017 Dec 6.

Klinik und Poliklinik für Innere Medizin A, Universitätsklinikum Greifswald.

In patients with ileus with dilated intestine in imaging studies, endoscopic decompression appears a feasible option. However, its use is often uncritical and without scientific evidence. Before considering endoscopic intervention, CT-imaging should differentiate between mechanical obstruction and paralytic ileus/intestinal pseudo-obstruction. Read More

Colorectal Dis 2017 Apr;19(4):O97-O102

Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris VII, Clichy, France.

Aim: To evaluate the contribution of CT for the management of patients with severe acute exacerbation of colitis (SAC) complicating inflammatory bowel disease (IBD); in particular, its contribution to surgical decision making.

Method: All patients who were admitted to our institution for SAC complicating IBD were divided into two groups: group A (those who received surgical treatment); and group B (those who received medical treatment). Admission CT results were compared between groups. Read More

Pediatr Emerg Care 2016 Nov;32(11):785-788

From the Departments of *Pediatric Surgery and †Pediatrics, University of Mannheim, Medical Faculty of Heidelberg, Mannheim, Germany.

Objectives: Enterocolitis remains the most significant cause of morbidity and mortality in Hirschsprung disease (HD). It could progress into toxic megacolon (TM)-acute dilatation of the colon as accompanying toxic complication of Hirschsprung enterocolitis. It is a devastating complication, especially in infants with so far undiagnosed HD. Read More

BMJ 2016 Oct 13;355:i5264. Epub 2016 Oct 13.

Department of Radiology, East Sussex Hospitals NHS Trust, Eastbourne, UK.

Anaesthesiol Intensive Ther 2016 ;48(2):146-8

Department of Anaesthesiology and Intensive Care, Medical Centre of Postgraduate Education, Warsaw, Poland.

Viszeralmedizin 2015 Aug 4;31(4):280-6. Epub 2015 Aug 4.

Medical Clinic I, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.

Background: Endoscopy is an essential diagnostic and therapeutic modality in the clinical care of inflammatory bowel disease (IBD) patients. Endoscopic therapy can be used for treatment of disease-related strictures, surveillance and resection of intraepithelial neoplasia, and treatment of fistulas or disease-related complications, and is currently being evaluated regarding its capacity in in vivo molecular imaging procedures.

Methods: A literature search using Medline and Science Citation Index was performed in March 2015. Read More

Pediatr Emerg Med Pract 2014 Jul;11(7):1-16; quiz 17-8

Inflammatory bowel disease includes both Crohn disease and ulcerative colitis. Pediatric-onset inflammatory bowel disease differs from adult inflammatory bowel disease in disease type, location, progression, and sex preponderance, and 20% to 30% of inflammatory bowel disease is diagnosed in childhood. Children are more likely than adults to present with extraintestinal manifestations of inflammatory bowel disease (with aphthous ulcers, joint involvement, and growth delay being the most common). Read More

Arch Dis Child Educ Pract Ed 2014 Oct 6;99(5):188, 200. Epub 2014 Feb 6.

Leicester Children's Hospital, Leicester Royal Infirmary, Leicester, UK.

Ann R Coll Surg Engl 2014 Jan;96(1):101E-103E

1Whittington Hospital NHS Trust, UK.

MELAS (mitochondrial cytopathy, encephalomyopathy, lactic acidosis and stroke-like episodes) is a syndrome in which signs and symptoms of gastrointestinal disease are uncommon if not rare. We describe the case of a young woman who presented as an acute surgical emergency, diagnosed as toxic megacolon necessitating an emergency total colectomy. MELAS syndrome was suspected postoperatively owing to persistent lactic acidosis and neurological symptoms. Read More

Case Rep Gastroenterol 2013 11;7(3):409-13. Epub 2013 Sep 11.

Computed Tomography and Magnetic Resonance Imaging Department, Sismanogleio General Hospital, Athens, Greece.

We present a rare case of toxic megacolon accompanied by necrosis of the colon due to chronic dilation caused by stenosis of the sigmoid colon as a complication of diverticulitis. The patient presented at the emergency department with diffuse abdominal pain, fever (38.8°C) and tachycardia (120 beats/min). Read More

BMJ Case Rep 2013 Sep 10;2013. Epub 2013 Sep 10.

Department of General Surgery, Kasturba Medical College, Manipal, Karnataka, India.

Cytomegalovirus (CMV) infection causes significant morbidty and mortality in immunopromised patients. Though it is usually silent in immunocompetent adults, rarely it can cause serious life-threatening complications. Gastrointestinal tract is one of the commonly involved organs, where it produces a spectrum of clinical manifestation ranging from mild non-specific abdominal pain and diarrhoea to severe infection with toxic megacolon and death. Read More

Ugeskr Laeger 2013 Aug;175(35):1965-6

Gastroenterologisk Afdeling, Medicinsk Center, Aalborg Universitetshospital.

A 38-year-old man with a ten year long history of primary sclerosing cholangitis without previous symptoms of inflammatory bowel disease was admitted to hospital after a few weeks with abdominal pain, diarrhoea and fever. A computed tomography revealed that the colon was dilated to a diameter of 17 cm. Based on a diagnosis of toxic megacolon, a subtotal colectomy and an ileostomy were carried out. Read More

BMJ 2013 Feb 14;346:f563. Epub 2013 Feb 14.

Department of Paediatric Gastroenterology, Hepatology and Nutrition, Yorkhill, Royal, Hospital for Sick Children, Glasgow G3 8SJ, UK.

Can J Gastroenterol 2012 Sep;26(9):627-30

Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, British Columbia.

Microscopic forms of colitis have been described, including collagenous colitis, a possibly heterogeneous disorder. Collagenous colitis most often appears to have an entirely benign clinical course that usually responds to limited treatment. Sometimes significant extracolonic disorders, especially arthritis, spondylitis, thyroiditis and skin disorders, such as pyoderma gangrenosum, dominate the clinical course and influence the treatment strategy. Read More

Intern Emerg Med 2013 Mar 26;8(2):185-6. Epub 2012 Aug 26.

Intern Emerg Med 2012 Oct 28;7(5):487-8. Epub 2012 Jul 28.