Toxic Megacolon

An acute form of MEGACOLON, severe pathological dilatation of the COLON. It is associated with clinical conditions such as ULCERATIVE COLITIS; CROHN DISEASE; AMEBIC DYSENTERY; or CLOSTRIDIUM ENTEROCOLITIS.

Also Known As:

Networked: 308 relevant articles (12 outcomes, 9 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Ulcerative Colitis
2.	Pseudomembranous Enterocolitis (Pseudomembranous Colitis)
3.	Crohn Disease (Crohn's Disease)
4.	Inflammatory Bowel Diseases (Inflammatory Bowel Disease)
5.	Ileus

Experts

1.	Remzi, Feza H: 4 articles (02/2015 - 07/2003)
2.	Spinelli, Antonino: 3 articles (10/2021 - 02/2020)
3.	Shen, Bo: 3 articles (01/2018 - 06/2013)
4.	Turner, Dan: 3 articles (08/2012 - 01/2009)
5.	Carvello, Michele: 2 articles (10/2021 - 02/2020)
6.	Watfah, Joseph: 2 articles (10/2021 - 02/2020)
7.	Abou Chakra, Claire Nour: 2 articles (01/2019 - 12/2015)
8.	Fortier, Louis-Charles: 2 articles (01/2019 - 12/2015)
9.	Garneau, Julian R: 2 articles (01/2019 - 12/2015)
10.	Katz, Kevin: 2 articles (01/2019 - 12/2015)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Toxic Megacolon:

1.	VancomycinFDA LinkGeneric 02/18/1984 - "The symptoms of many infants with toxin settled spontaneously, but one child became acutely and severely ill and developed a toxic megacolon and five others required, and responded to, vancomycin. " 01/01/2016 - "The group that received adjunctive intracolonic vancomycin had higher rates of toxic megacolon, intensive care unit (ICU) admission, and colectomy, and yet maintained a similar mortality rate as the group that received only standard treatment. " 01/01/1992 - "Despite specific oral treatment (against Clostridium difficile) by vancomycin, toxic megacolon required urgent subtotal colectomy with ileostomy and sigmoidostomy. " 07/01/2004 - "Colostomy with vancomycin administration as an effective treatment for toxic megacolon associated with fulminant pseudomembranous colitis: a case report." 07/01/2001 - "Colonoscopic decompression and intracolonic vancomycin administration in the management of severe, acute, pseudomembranous colitis associated with ileus and toxic megacolon is feasible, safe, and effective in approximately 57% to 71% of cases."
2.	SteroidsIBA 01/01/1988 - "1 patient on SASP had to be removed from the study due to side effects, while 3 patients on SAB were removed due to rapid worsening of the disease requiring either surgery (1 patient with toxic megacolon) or additional steroid treatment (2 patients). " 04/01/1979 - "Steroids and toxic megacolon." 07/01/1987 - "Endoscopic colonic decompression of toxic megacolon, placement of colonic tube, and steroid colonclysis." 10/01/1978 - "The place of steroids in the therapy of toxic megacolon." 01/01/2014 - "Intravenous steroids are often recommended for patients with toxic megacolon secondary to ulcerative colitis. "
3.	Infliximab (Remicade)FDA Link 04/01/2012 - "This is the first report of treatment of Crohn disease-associated toxic megacolon with infliximab." 04/01/2012 - "Infliximab in Crohn's disease-associated toxic megacolon." 01/01/2004 - "Infliximab in the treatment of ulcerative colitis with toxic megacolon." 11/01/2004 - "In two cases of refractory ulcerative colitis, one case who showed clinical manifestation of toxic megacolon had improved and avoided the colectomy, but the other case did not respond to the infusion of infliximab and underwent colon resection. " 07/01/2007 - "[Severe ulcerative colitis, with toxic megacolon, resolved with infliximab therapy]."
4.	Tacrolimus (Prograf)FDA LinkGeneric 05/01/2003 - "Rescue therapy with tacrolimus in a patient with toxic megacolon." 05/01/2003 - "We report an unusual case of fulminant steroid-refractory ulcerative colitis complicated by toxic megacolon treated successfully with the immunosuppressant tacrolimus. " 08/01/2015 - "In steroid-refractory UC, early intensive therapy using anti-tumor necrosis factor (TNF) antibodies or the calcineurin inhibitors cyclosporine and tacrolimus is indicated in any case to prevent progression to a toxic megacolon and/or to avoid proctocolectomy. "
5.	Prednisolone (Predate)FDA LinkGeneric 12/01/2007 - "One patient had life-threatening symptoms (toxic megacolon, pneumonitis, disseminated intravascular coagulation) despite high-dose prednisolone. " 10/01/1997 - "Intensive intravenous prednisolone therapy with total parenteral nutrition was dramatically effective in treating the toxic megacolon and inducing remission in Crohn's disease and afterward, remission of the nephrotic syndrome. "
6.	Morphine (MS Contin)FDA LinkGeneric 11/01/2006 - "We have demonstrated the safe and effective use of ketamine analgesia in children with toxic megacolon, a condition in which the child is in severe pain and morphine is contraindicated."
7.	KetamineFDA LinkGeneric 11/01/2006 - "We have demonstrated the safe and effective use of ketamine analgesia in children with toxic megacolon, a condition in which the child is in severe pain and morphine is contraindicated."
8.	Immunosuppressive Agents (Immunosuppressants)IBA 05/01/2003 - "We report an unusual case of fulminant steroid-refractory ulcerative colitis complicated by toxic megacolon treated successfully with the immunosuppressant tacrolimus. "
9.	ElectrolytesIBA 11/01/1980 - "Results of this study indicate that the severity of the electrolyte and metabolic disorder appears to be an important risk factor in toxic megacolon. " 11/01/1980 - "Intensive fluid and electrolyte replacement should therefore be considered a crucial point for successful management of toxic megacolon." 11/20/2023 - "It can lead to pseudomembranous colitis characterized by electrolyte disturbances, toxic megacolon, and septic shock. " 08/01/1996 - "In aged patients, with severe concomitant diseases, may appear complications such as dehydration, electrolyte imbalance, hypotension and toxic megacolon, which occasionally may lead to fatal outcome. " 01/01/2019 - "Complications of infection with this pathogen include severe diarrhea, causing electrolyte imbalances, dehydration, hemodynamic instability, toxic megacolon, shock, and death. "
10.	Nitric Oxide (Nitrogen Monoxide)FDA Link 08/01/1998 - "Clinical studies have shown that nitric oxide is elevated in several inflammatory bowel diseases and other secretory conditions including ulcerative colitis, Crohn's disease, toxic megacolon, diverticulitis, infectious gastroenteritis, and infantile methemoglobinemia. "

Therapies and Procedures

1.	Decompression 10/01/1988 - "Most reports on the management of toxic megacolon stress the need for early surgical intervention, but our success in decompression with the addition of the "rolling technique" suggests an improvement in the nonoperative management of toxic megacolon." 01/01/1989 - "Endoscopic decompression in "toxic megacolon"." 10/01/1988 - "Medical decompression of toxic megacolon by "rolling". " 09/01/1988 - "This method of decompression has allowed us to perform colonic resection in all patients with toxic megacolon seen in recent years. " 11/01/1988 - "It is a new therapeutic choice for the treatment of the Ogilvie syndrome, toxic megacolon and other morbid entities, which may permit the performance of the procedure and require decompression of the colon, which proved to be extremely effective in the treatment of a patient with the Ogilvie syndrome."
2.	Therapeutics 11/01/1985 - "The therapy was effective in 31 (57%) of 54 infusions, including three of five cases of toxic megacolon. " 06/01/1988 - "If toxic megacolon is present, an initial trial of medical therapy is warranted in order to allow a single-staged operation to be performed electively." 01/01/2022 - "Two patients underwent urgent surgery for progressive toxic megacolon and ineffective therapy. " 01/01/2015 - "We report a 26 year old primigravida female who presented with toxic megacolon during the third trimester of pregnancy, unresponsive to medical therapy. " 08/02/2013 - "We underscore the importance of early diagnosis of toxic megacolon and rapid surgical intervention if improvement is not observed on medical therapy. "
3.	Ileostomy 06/01/2022 - "We describe the case of a young pregnant woman with terminal ileostomy after toxic megacolon. " 09/26/2017 - "A colonoscopy demonstrated severe mucosal ulceration down to the muscular layer.A subtotal colectomy and end ileostomy formation was performed with intraoperative findings of toxic megacolon with near perforation. " 08/26/2013 - "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. " 12/01/2012 - "Subtotal colectomy with ileostomy remains the standard of care when toxic megacolon, perforation, or an acute surgical abdomen is present, but mortality rates are high. " 03/01/2007 - "He was found to have toxic megacolon on plain X-ray and subsequently underwent total colectomy and ileostomy. "
4.	Colostomy 01/01/2016 - "Blowhole Colostomy for Clostridium difficile-Associated Toxic Megacolon." 09/01/1988 - "We have not resorted to blowhole colostomies in cases of toxic megacolon, as this leaves the colon, which is the septic source, within the abdominal cavity. " 07/01/2003 - "The blow-hole colostomy-ileostomy procedure is still indicated for select patients with toxic megacolon and large-bowel obstruction. " 12/25/2021 - "For toxic megacolon, colostomy can be done for mild cases, and for severe infections, subtotal colorectal resection is required. " 12/01/2019 - "After graduating from Harvard Medical School and beginning his residency at Peter Bent Brigham Hospital, Dr. Swenson observed that patients with Hirschsprung's disease and toxic megacolon resumed normal bowel function after placement of transverse colostomies. "
5.	Colectomy 10/30/2021 - "During admission, the patient has to be closely observed for the possible development of toxic megacolon or perforation, which should prompt emergency colectomy. " 01/01/2021 - "The other 5 patients developed toxic megacolon, and eventually required total abdominal colectomy. " 07/01/2020 - "All patients 18 to 89 years of age who underwent colectomy for toxic megacolon resulting from C. " 02/10/2020 - "During admission, the patient has to be closely observed for the possible development of toxic megacolon or perforation, which should prompt emergency colectomy. " 05/01/2019 - "Potential complications include intensive care unit (ICU) admission, development of toxic megacolon, need for colectomy, and death. "