TY - JOUR
T1 - Life-threatening complications of IBD
T2 - How to handle fulminant colitis and toxic megacolon: Clinical features, key diagnostic tests, and treatment options
AU - Stein, R. B.
AU - Hanauer, S. B.
PY - 1998/1/1
Y1 - 1998/1/1
N2 - Fulminant colitis and toxic megacolon are life-threatening complications of acute inflammatory bowel disease (IBD) that require aggressive therapy. Predisposing factors include dosage reduction of medications for IBD; enteric infections; and certain drugs, including narcotics, antidiarrheals, and anticholinergics. Diagnostic features include diarrhea (more than six stools per day); hematochezia; fever; abdominal tenderness, distention, or rebound tenderness; increased C-reactive protein concentrations; elevated erythrocyte sedimentation rate; and hypokalemia. Diagnosis is secured with abdominal radiography and limited flexible sigmoidoscopy (with minimal air insufflation). Medical treatment is based largely on corticosteroids (hydrocortisone or methylprednisolone) and cyclosporine. Absolute indications for colectomy include perforation, massive hemorrhage, and clinical deterioration despite intensive medical therapy.
AB - Fulminant colitis and toxic megacolon are life-threatening complications of acute inflammatory bowel disease (IBD) that require aggressive therapy. Predisposing factors include dosage reduction of medications for IBD; enteric infections; and certain drugs, including narcotics, antidiarrheals, and anticholinergics. Diagnostic features include diarrhea (more than six stools per day); hematochezia; fever; abdominal tenderness, distention, or rebound tenderness; increased C-reactive protein concentrations; elevated erythrocyte sedimentation rate; and hypokalemia. Diagnosis is secured with abdominal radiography and limited flexible sigmoidoscopy (with minimal air insufflation). Medical treatment is based largely on corticosteroids (hydrocortisone or methylprednisolone) and cyclosporine. Absolute indications for colectomy include perforation, massive hemorrhage, and clinical deterioration despite intensive medical therapy.
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M3 - Review article
AN - SCOPUS:0032453834
SN - 1040-0257
VL - 13
SP - 518
EP - 525
JO - Journal of Critical Illness
JF - Journal of Critical Illness
IS - 8
ER -