علاج الميغاكولون السام في التهاب القولون التقرحي الحاد الشديد مع أكثر من ستة براز دموي يومياً

References

DOI: 10.1186/s13017-021-00362-3

• Acute severe ulcerative colitis (ASUC), historically referred to as “fulminant” or “toxic” colitis, represents a severe form of acute colitis involving more than six bloody stools per day accompanied by at least one systemic sign of toxicity including tachycardia, fever, anemia (hemoglobin <10.5 g/dL), or elevated erythrocyte sedimentation rate (ESR) greater than 30 mm/h.
• The mainstay of medical management of ASUC is intravenous (IV) corticosteroids.
• In addition, patients with ASUC should receive IV hydration/resuscitation, electrolyte replacement as indicated, deep vein thrombosis (DVT) prophylaxis, blood transfusions as needed, and total parenteral nutrition if malnourished.
• More than eight bowel movements per day on day 3 of corticosteroid treatment or three to eight bowel movements along with a C-reactive protein (CRP) greater than 45 mg/L predicted colectomy in 85% of patients.
• Additionally, the presence of hypoalbuminemia, colonic dilation, ESR greater than 75 mm/h, and fever greater than 38°C predicted failure of steroids.