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Chronic Ulcerative Colitis Complicated by Toxic Megacolon

Chronic Ulcerative Colitis Complicated by Toxic Megacolon Abstract CHRONIC ulcerative colitis, a rare lesion in infancy,1 presents particular problems of management. Although childhood chronic ulcerative colitis was described first by Helmholz2 in 1923 and a number of cases have been reported since,3-5 it is a diagnosis made reluctantly, in part because of the possibility of surgical intervention with the consequence of lifetime ileostomy. Indications for surgery in childhood chronic ulcerative colitis in some instances are clear cut, eg, perforation, bleeding, or obstruction. The continual and real threat that colon carcinoma will develop with long-term disease also may make surgery imperative. A more difficult decision regarding surgical intervention is the case of recurrent bouts of diarrhea. Toxic megacolon may be defined as an acute dilatation of the proximal colon occurring in a patient with chronic ulcerative colitis; it is associated with abdominal distension, debilitation, fever, dehydration, and prostration. Although toxic megacolon can, on occasion, complicate pediatric References 1. Fonkalsrud, E.W., and Barker, W.F.: Ulcerative Colitis in Infancy , Surgery 54:819, 1963. 2. Helmholz, H.F.: Chronic Ulcerative Colitis in Childhood , Amer J Dis Child 26:418, 1923. 3. Michener, W.N.; Brown, C.H.; and Turnbull, R.B., Jr.: Ulcerative Colitis in Children: II. Medical and Surgical Therapy , Amer J Dis Child 108:236, 1964.Crossref 4. Jackman, R.J.; Bargen, J.A.; and Helmholz, H.F.: Life Histories of 95 Children With Chronic Ulcerative Colitis , Amer J Dis Child 59:459, 1950. 5. Valdes-Dapena, M., and Valdes-Dapena, A.: Ulcerative Colitis in Infants , Gastroenterology 18:315, 1951. 6. Roth, J.L.A., et al: Toxic Megacolon and Ulcerative Colitis , Gastroenterology 37:239, 1959. 7. Smith, F.W., et al: Fulminant Ulcerative Colitis With Toxic Dilatation of the Colon: Medical and Surgical Management of Eleven Cases With Observations Regarding Etiology , Gastroenterology 42: 233, 1962. 8. Prohaska, J.V.; Greer, D.; and Ryan, J.F.: Acute Dilatation of the Colon in Ulcerative Colitis , Arch Surg 89:24, 1964.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Chronic Ulcerative Colitis Complicated by Toxic Megacolon

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Publisher
American Medical Association
Copyright
Copyright © 1966 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1966.01330040095017
Publisher site
See Article on Publisher Site

Abstract

Abstract CHRONIC ulcerative colitis, a rare lesion in infancy,1 presents particular problems of management. Although childhood chronic ulcerative colitis was described first by Helmholz2 in 1923 and a number of cases have been reported since,3-5 it is a diagnosis made reluctantly, in part because of the possibility of surgical intervention with the consequence of lifetime ileostomy. Indications for surgery in childhood chronic ulcerative colitis in some instances are clear cut, eg, perforation, bleeding, or obstruction. The continual and real threat that colon carcinoma will develop with long-term disease also may make surgery imperative. A more difficult decision regarding surgical intervention is the case of recurrent bouts of diarrhea. Toxic megacolon may be defined as an acute dilatation of the proximal colon occurring in a patient with chronic ulcerative colitis; it is associated with abdominal distension, debilitation, fever, dehydration, and prostration. Although toxic megacolon can, on occasion, complicate pediatric References 1. Fonkalsrud, E.W., and Barker, W.F.: Ulcerative Colitis in Infancy , Surgery 54:819, 1963. 2. Helmholz, H.F.: Chronic Ulcerative Colitis in Childhood , Amer J Dis Child 26:418, 1923. 3. Michener, W.N.; Brown, C.H.; and Turnbull, R.B., Jr.: Ulcerative Colitis in Children: II. Medical and Surgical Therapy , Amer J Dis Child 108:236, 1964.Crossref 4. Jackman, R.J.; Bargen, J.A.; and Helmholz, H.F.: Life Histories of 95 Children With Chronic Ulcerative Colitis , Amer J Dis Child 59:459, 1950. 5. Valdes-Dapena, M., and Valdes-Dapena, A.: Ulcerative Colitis in Infants , Gastroenterology 18:315, 1951. 6. Roth, J.L.A., et al: Toxic Megacolon and Ulcerative Colitis , Gastroenterology 37:239, 1959. 7. Smith, F.W., et al: Fulminant Ulcerative Colitis With Toxic Dilatation of the Colon: Medical and Surgical Management of Eleven Cases With Observations Regarding Etiology , Gastroenterology 42: 233, 1962. 8. Prohaska, J.V.; Greer, D.; and Ryan, J.F.: Acute Dilatation of the Colon in Ulcerative Colitis , Arch Surg 89:24, 1964.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Oct 1, 1966

References