Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2015
[Toxic megacolon].
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Leppkes M, Ganslmayer M, Strauß R, Neurath M F
Аннотация
BACKGROUND: Toxic megacolon constitutes a feared, life-threatening complication of severe intestinal inflammation and is a challenge for interdisciplinary medical care.
OBJECTIVES: Specific aspects of conservative treatment based on current scientific evidence derived from guidelines, qualified reviews, and scientific studies are presented, which provide a rational approach and maximize therapeutic success.
MATERIALS AND METHODS: This work is based on a selective literature review and the authors' experience of many years in gastroenterology and intensive care.
RESULTS: Toxic megacolon requires a rapid interdisciplinary assessment. Depending on the underlying etiology, an individual treatment concept needs to be developed. If an infectious or inflammatory cause is probable, a conservative approach can reduce perioperative morbidity and mortality. A step-wise approach with controlled reevaluations of the response to therapy after 72 h and 7 days avoids uncontrolled delay of surgical options further ensuring patient safety.
CONCLUSION: Despite a decreasing incidence of toxic megacolon, it remains an interdisciplinary therapeutic challenge.
OBJECTIVES: Specific aspects of conservative treatment based on current scientific evidence derived from guidelines, qualified reviews, and scientific studies are presented, which provide a rational approach and maximize therapeutic success.
MATERIALS AND METHODS: This work is based on a selective literature review and the authors' experience of many years in gastroenterology and intensive care.
RESULTS: Toxic megacolon requires a rapid interdisciplinary assessment. Depending on the underlying etiology, an individual treatment concept needs to be developed. If an infectious or inflammatory cause is probable, a conservative approach can reduce perioperative morbidity and mortality. A step-wise approach with controlled reevaluations of the response to therapy after 72 h and 7 days avoids uncontrolled delay of surgical options further ensuring patient safety.
CONCLUSION: Despite a decreasing incidence of toxic megacolon, it remains an interdisciplinary therapeutic challenge.