Acute colitis

Salmonella is a rare cause of toxic megacolon, but it can behave opportunistically in patients with ulcerative colitis. S. enteritidis phage type 4 is typically transmitted via raw or uncooked eggs in most cases of salmonellosis attributed to this organism. The disease is rapidly progressive, and death may ensue due to septicaemia and/or perforation. Toxic megacolon is treated aggressively, initially medically, with high-dose steroids and attention to fluid balance, ulcerative colitis being the usual working diagnosis. Once Salmonella is cultured, appropriate antibiotics are commenced. Non-surgical decompression may be appropriate in some cases, but early surgical intervention is required for failed response to these measures or rapid deterioration in the patient's condition. Following initial surgery - often subtotal colectomy and ileostomy formation - continuity may be restored. For most patients with ulcerative colitis ileal pouch anal anastomosis is the operation of choice, but ileorectal anastomosis may be safely performed for Salmonella-induced toxic megacolon. Prevention is better than cure, and therefore health education needs to reinforce avoidance of use of raw or uncooked eggs.

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Caribbean Traveler with Diarrhea and Abdominal Distention

Fonte

1990

Hospital Practice

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Acute colitis

Cited by 3 publications

References 26 publications

Fulminant amebic colitis

Fulminant amebic colitis

Toxic megacolon due to Salmonella : a case report and review of the literature

Caribbean Traveler with Diarrhea and Abdominal Distention

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