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Myxedema Megacolon

Myxedema Megacolon Abstract For many years, hypothyroidism frequently has been associated with a variety of gastrointestinal manifestations, including constipation, distention, flatulence, ileus, atrophic gastritis, and atony and dilatation of the esophagus, stomach, small intestine, colon, and gallbladder. The occasional occurrence of a potentially life-threatening extension of the decreased gastrointestinal motility of hypothyroidism—myxedema megacolon—must be reemphasized. Megacolon is characterized by a massive distention of the colon and is usually secondary to the absence of submucous (Meissner's) and myenteric (Auerbach's) plexuses in the distal colon. However, it may also arise secondary to a variety of systemic diseases, including scleroderma, dermatomyositis, polymyositis, amyloidosis, myotonic dystrophy, diabetes mellitus, and Chagas' disease, and from drugs, such as phenothiazines, tricyclic antidepressants, and antiparkinsonian agents.1 Reports of myxedema megacolon have appeared in medical literature over the last several decades.2-11 It is difficult to determine the incidence of this unusual complication, but in a review by Watanakunakorn et al References 1. Faulk DL, Anuras S, Christensen J: Chronic intestinal pseudoobstruction. Gastroenterology 1978;74:922-931. 2. Bastenie PA: Paralytic ileus in severe hypothyroidism. Lancet 1946;1:413-416.Crossref 3. Bacharach T, Evans JR: Enlargement of the colon secondary to hypothyroidism. Ann Intern Med 1957;57:121-124. 4. Douglas AC, Jacobson SD: Pathologic changes in adult myxedema: Survey of ten necropsies. J Clin Endocrinol Metabol 1957;17:1354.Crossref 5. Hohl RD, Nixon RK: Myxedema ileus. Arch Intern Med 1965;115:145-150.Crossref 6. Case 24-1965, Case records of the Massachusetts General Hospital: Weekly clinicopathological exercises. New Engl J Med 1965;272:1118-1127.Crossref 7. Chadha JS, Ashby DW, Cowan WK: Fatal intestinal atony in myxedema. Br Med J 1969;3:398.Crossref 8. Wells I, Smith B, Hinton M: Acute ileus in myxedema. Br Med J 1977;1:211-212.Crossref 9. Salerno N, Grey N: Myxedema pseudoobstruction. AJR 1978;130:175-176.Crossref 10. Burrell M, Cronan J, Megna D, et al: Myxedema megacolon. Gastrointest Radiol 1980;5:181-186.Crossref 11. Batalis T, Muers M, Royle GT: Treatment with intravenous triiodothyronine of colonic pseudoobstruction. Br J Surg 1981;68: 439.Crossref 12. Watanakunakorn C, Hodges RE, Evans TC: Myxedema: A study of 400 cases. Arch Intern Med 1965;116:183-190.Crossref 13. Duret RL, Bastenie PA: Intestinal disorders in hypothyroidism: Clinical and manometric studies. Dig Dis Sci 1971;16: 723-727.Crossref 14. Green WL: Guidelines for the treatment of myxedema. Med Clin North Am 1968;52:431-450. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Myxedema Megacolon

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Myxedema Megacolon

Abstract

Abstract For many years, hypothyroidism frequently has been associated with a variety of gastrointestinal manifestations, including constipation, distention, flatulence, ileus, atrophic gastritis, and atony and dilatation of the esophagus, stomach, small intestine, colon, and gallbladder. The occasional occurrence of a potentially life-threatening extension of the decreased gastrointestinal motility of hypothyroidism—myxedema megacolon—must be reemphasized. Megacolon is...
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References (14)

Publisher
American Medical Association
Copyright
Copyright © 1985 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1985.00360020051007
Publisher site
See Article on Publisher Site

Abstract

Abstract For many years, hypothyroidism frequently has been associated with a variety of gastrointestinal manifestations, including constipation, distention, flatulence, ileus, atrophic gastritis, and atony and dilatation of the esophagus, stomach, small intestine, colon, and gallbladder. The occasional occurrence of a potentially life-threatening extension of the decreased gastrointestinal motility of hypothyroidism—myxedema megacolon—must be reemphasized. Megacolon is characterized by a massive distention of the colon and is usually secondary to the absence of submucous (Meissner's) and myenteric (Auerbach's) plexuses in the distal colon. However, it may also arise secondary to a variety of systemic diseases, including scleroderma, dermatomyositis, polymyositis, amyloidosis, myotonic dystrophy, diabetes mellitus, and Chagas' disease, and from drugs, such as phenothiazines, tricyclic antidepressants, and antiparkinsonian agents.1 Reports of myxedema megacolon have appeared in medical literature over the last several decades.2-11 It is difficult to determine the incidence of this unusual complication, but in a review by Watanakunakorn et al References 1. Faulk DL, Anuras S, Christensen J: Chronic intestinal pseudoobstruction. Gastroenterology 1978;74:922-931. 2. Bastenie PA: Paralytic ileus in severe hypothyroidism. Lancet 1946;1:413-416.Crossref 3. Bacharach T, Evans JR: Enlargement of the colon secondary to hypothyroidism. Ann Intern Med 1957;57:121-124. 4. Douglas AC, Jacobson SD: Pathologic changes in adult myxedema: Survey of ten necropsies. J Clin Endocrinol Metabol 1957;17:1354.Crossref 5. Hohl RD, Nixon RK: Myxedema ileus. Arch Intern Med 1965;115:145-150.Crossref 6. Case 24-1965, Case records of the Massachusetts General Hospital: Weekly clinicopathological exercises. New Engl J Med 1965;272:1118-1127.Crossref 7. Chadha JS, Ashby DW, Cowan WK: Fatal intestinal atony in myxedema. Br Med J 1969;3:398.Crossref 8. Wells I, Smith B, Hinton M: Acute ileus in myxedema. Br Med J 1977;1:211-212.Crossref 9. Salerno N, Grey N: Myxedema pseudoobstruction. AJR 1978;130:175-176.Crossref 10. Burrell M, Cronan J, Megna D, et al: Myxedema megacolon. Gastrointest Radiol 1980;5:181-186.Crossref 11. Batalis T, Muers M, Royle GT: Treatment with intravenous triiodothyronine of colonic pseudoobstruction. Br J Surg 1981;68: 439.Crossref 12. Watanakunakorn C, Hodges RE, Evans TC: Myxedema: A study of 400 cases. Arch Intern Med 1965;116:183-190.Crossref 13. Duret RL, Bastenie PA: Intestinal disorders in hypothyroidism: Clinical and manometric studies. Dig Dis Sci 1971;16: 723-727.Crossref 14. Green WL: Guidelines for the treatment of myxedema. Med Clin North Am 1968;52:431-450.

Journal

Archives of Internal Medicine – American Medical Association

Published: Feb 1, 1985

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