Hemorrhage
Toxic megacolon
Develops in advanced disease when all the layers of the colon become involved
Presentation
Severely ill
Abdomen distended, tender, peritonitis
Fever, tachycardia
Leukocytosis (may be masked if patient taking steroids)
Perforation results in high mortality
Abdominal x-ray: long, continuous segment of air-filled colon >6cm in diameter
Perirectal fistula
Perirectal abscess
Obstruction (due to stricture)
Carcinoma
Develops in advanced disease when all the layers of the colon become involved
Presentation
Severely ill
Abdomen distended, tender, peritonitis
Fever, tachycardia
Leukocytosis (may be masked if patient taking steroids)
Perforation results in high mortality
Abdominal x-ray: long, continuous segment of air-filled colon >6cm in diameter
Severely ill
Abdomen distended, tender, peritonitis
Fever, tachycardia
Leukocytosis (may be masked if patient taking steroids)
Parenteral vs PO depending on severity
PO: prednisone 40mg x 2wks, then decrease by 5mg per week
PO: prednisone 40mg x 2wks, then decrease by 5mg per week
Ulcerative colitis
Infectious colitis
Stercoral colitis
Ischemic colitis
Crohn's disease
CMV colitis
Irritable bowel syndrome
Crohn's colitis