Megacolon

Aka: Megacolon, Megarectum, Ogilvie's Syndrome

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II. Definition: Bowel distention based on abdominal XRay

  1. Rectosigmoid or descending colon >6.5 cm diameter or
  2. Ascending colon >8 cm diameter or
  3. Cecal diameter >12 cm

III. Causes

  1. Toxic Megacolon
    1. Inflammatory Bowel Disease
      1. Ulcerative Colitis
      2. Crohn's Disease
    2. Infectious Colitis
      1. Clostridium difficile (Pseudomembranous colitis)
      2. Amebic colitis
  2. Congenital Megacolon (Hirschsprung's Disease)
  3. Acquired Megacolon
    1. Idiopathic Megacolon
    2. Trypanosoma cruzi (Chaga's Disease)
      1. Incidence in U.S. is increasing
    3. Intestinal pseudo-obstruction (colon dysmotility)
      1. Acute due to medical cause (Ogilvie's Syndrome)
      2. Acute Causes
        1. Abdominal or orthopedic surgery
        2. Spinal Cord Injury
        3. Serious cardiovascular disorder

IV. References

  1. Phillips in Feldman (1998) GI Disease, p. 1810-12

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