Idiopathic Megacolon—Short Review
Introduction: Idiopathic megacolon (IM) is a rare condition with a more or less known etiology, which involves management challenges, especially therapeutic, and both gastroenterology and surgery services. With insufficiently drawn out protocols, but with occasionally formidable complications, the c...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-11-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/11/2112 |
| _version_ | 1827676810104537088 |
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| author | Adrian Constantin Florin Achim Dan Spinu Bogdan Socea Dragos Predescu |
| author_facet | Adrian Constantin Florin Achim Dan Spinu Bogdan Socea Dragos Predescu |
| author_sort | Adrian Constantin |
| collection | DOAJ |
| description | Introduction: Idiopathic megacolon (IM) is a rare condition with a more or less known etiology, which involves management challenges, especially therapeutic, and both gastroenterology and surgery services. With insufficiently drawn out protocols, but with occasionally formidable complications, the condition management can be difficult for any general surgery team, either as a failure of drug therapy (in the context of a known case, initially managed by a gastroenterologist) or as a surgical emergency (in which the diagnostic surprise leads additional difficulties to the tactical decision), when the speed imposed by the severity of the case can lead to inadequate strategies, with possibly critical consequences. Method: With such a motivation, and having available experience limited by the small number of cases (described by all medical teams concerned with this pathology), the revision of the literature with the update of management landmarks from the surgical perspective of the pathology appears as justified by this article. Results: If the diagnosis of megacolon is made relatively easily by imaging the colorectal dilation (which is associated with initial and/or consecutive clinical aspects), the establishing of the diagnosis of idiopathic megacolon is based in practice almost exclusively on a principle of exclusion, and after evaluating the absence of some known causes that can lead to the occurrence of these anatomic and clinical changes, mimetically, clinically, and paraclinically, with IM (intramural aganglionosis, distal obstructions, intoxications, etc.). If the etiopathogenic theories, based on an increase in the performance of the arsenal of investigations of the disease, have registered a continuous improvement and an increase of objectivity, unfortunately, the curative surgical treatment options still revolve around the same resection techniques. Moreover, the possibility of developing a form of etiopathogenic treatment seems as remote as ever. |
| first_indexed | 2024-03-10T05:34:29Z |
| format | Article |
| id | doaj.art-7146f234d0104554b66ba995c2d6c411 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T05:34:29Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-7146f234d0104554b66ba995c2d6c4112023-11-22T23:02:32ZengMDPI AGDiagnostics2075-44182021-11-011111211210.3390/diagnostics11112112Idiopathic Megacolon—Short ReviewAdrian Constantin0Florin Achim1Dan Spinu2Bogdan Socea3Dragos Predescu4General and Esophageal Clinic, Sf. Maria Clinical Hospital Bucharest, Carol Davila University of Medicine and Pharmacy, 011172 Bucharest, RomaniaGeneral and Esophageal Clinic, Sf. Maria Clinical Hospital Bucharest, Carol Davila University of Medicine and Pharmacy, 011172 Bucharest, RomaniaDepartment of Urology, Central Military Emergency University Hospital Bucharest, Carol Davila University of Medicine and Pharmacy, 010825 Bucharest, RomaniaDepartment of Surgery, Sf. Pantelimon Emergency Clinical Hospital Bucharest, Carol Davila University of Medicine and Pharmacy, 021659 Bucharest, RomaniaGeneral and Esophageal Clinic, Sf. Maria Clinical Hospital Bucharest, Carol Davila University of Medicine and Pharmacy, 011172 Bucharest, RomaniaIntroduction: Idiopathic megacolon (IM) is a rare condition with a more or less known etiology, which involves management challenges, especially therapeutic, and both gastroenterology and surgery services. With insufficiently drawn out protocols, but with occasionally formidable complications, the condition management can be difficult for any general surgery team, either as a failure of drug therapy (in the context of a known case, initially managed by a gastroenterologist) or as a surgical emergency (in which the diagnostic surprise leads additional difficulties to the tactical decision), when the speed imposed by the severity of the case can lead to inadequate strategies, with possibly critical consequences. Method: With such a motivation, and having available experience limited by the small number of cases (described by all medical teams concerned with this pathology), the revision of the literature with the update of management landmarks from the surgical perspective of the pathology appears as justified by this article. Results: If the diagnosis of megacolon is made relatively easily by imaging the colorectal dilation (which is associated with initial and/or consecutive clinical aspects), the establishing of the diagnosis of idiopathic megacolon is based in practice almost exclusively on a principle of exclusion, and after evaluating the absence of some known causes that can lead to the occurrence of these anatomic and clinical changes, mimetically, clinically, and paraclinically, with IM (intramural aganglionosis, distal obstructions, intoxications, etc.). If the etiopathogenic theories, based on an increase in the performance of the arsenal of investigations of the disease, have registered a continuous improvement and an increase of objectivity, unfortunately, the curative surgical treatment options still revolve around the same resection techniques. Moreover, the possibility of developing a form of etiopathogenic treatment seems as remote as ever.https://www.mdpi.com/2075-4418/11/11/2112idiopathic megacolonetiopathogenic theories of idiopathic megacolonsurgical treatment |
| spellingShingle | Adrian Constantin Florin Achim Dan Spinu Bogdan Socea Dragos Predescu Idiopathic Megacolon—Short Review Diagnostics idiopathic megacolon etiopathogenic theories of idiopathic megacolon surgical treatment |
| title | Idiopathic Megacolon—Short Review |
| title_full | Idiopathic Megacolon—Short Review |
| title_fullStr | Idiopathic Megacolon—Short Review |
| title_full_unstemmed | Idiopathic Megacolon—Short Review |
| title_short | Idiopathic Megacolon—Short Review |
| title_sort | idiopathic megacolon short review |
| topic | idiopathic megacolon etiopathogenic theories of idiopathic megacolon surgical treatment |
| url | https://www.mdpi.com/2075-4418/11/11/2112 |
| work_keys_str_mv | AT adrianconstantin idiopathicmegacolonshortreview AT florinachim idiopathicmegacolonshortreview AT danspinu idiopathicmegacolonshortreview AT bogdansocea idiopathicmegacolonshortreview AT dragospredescu idiopathicmegacolonshortreview |