Leppkes M, Ganslmayer M, Strauß R, Neurath M F
Medizinische Klinik 1, Universitätsklinik Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Deutschland.
Med Klin Intensivmed Notfmed. 2015 Oct;110(7):500-5. doi: 10.1007/s00063-015-0076-1. Epub 2015 Sep 14.
Toxic megacolon constitutes a feared, life-threatening complication of severe intestinal inflammation and is a challenge for interdisciplinary medical care.
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.
This work is based on a selective literature review and the authors' experience of many years in gastroenterology and intensive care.
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.
Despite a decreasing incidence of toxic megacolon, it remains an interdisciplinary therapeutic challenge.
中毒性巨结肠是严重肠道炎症令人恐惧的、危及生命的并发症，对跨学科医疗护理而言是一项挑战。
介绍基于指南、高质量综述及科学研究得出的当前科学证据的保守治疗的具体方面，其提供了一种合理的方法并使治疗成功率最大化。
本研究基于选择性文献综述以及作者们在胃肠病学和重症监护领域多年的经验。
中毒性巨结肠需要快速的跨学科评估。根据潜在病因，需制定个体化的治疗方案。如果可能是感染性或炎症性病因，保守治疗方法可降低围手术期发病率和死亡率。采用在72小时和7天后对治疗反应进行控制性重新评估的逐步方法，可避免手术选择的无控制延迟，进一步确保患者安全。
尽管中毒性巨结肠的发病率在下降，但它仍然是一个跨学科的治疗挑战。
