Colorectal Emergencies and Related Complications: A Comprehensive Imaging Review—Imaging of Colitis and Complications

Maddu, Kiran; Mittal, Pardeep K.; Shuaib, Waqas; Tewari, Anuj; Ibraheem, Oluwayemisi; Khosa, Faisal

doi:10.2214/ajr.13.12250

Cited by 23 publications

(10 citation statements)

References 49 publications

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“…8 Etiology UC and CD are important etiologies for TM making it evident that any inflammatory condition of the colon could predispose to TM. 5,25,26 TM is a rare but potentially lethal complication of any disease that causes inflammation of the colon, including IBD and Infectious etiologies such as C. diff and cytomegalovirus colitis. 5,27,28 Other precipitating factors for TM include anti-motility agents, such as anticholinergic medications and narcotics, electrolyte derangements, such as hypokalemia, and diagnostic procedures like barium enema and colonoscopy.…”

Section: Epidemiologymentioning

confidence: 99%

<p>Toxic Megacolon: Background, Pathophysiology, Management Challenges and Solutions</p>

Desai¹,

Elnaggar²,

Hanfy³

et al. 2020

CEG

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Toxic megacolon (TM) is one of the fatal complications of inflammatory bowel disease (IBD) or any infectious etiology of the colon that is characterized by total or partial nonobstructive colonic dilatation and systemic toxicity. It is associated with high morbidity and mortality, and surgical management is necessary for the majority of the cases. An accurate history and physical examination, plain radiographs of the abdomen, sigmoidoscopy, and, most important of all, awareness of the condition facilitate diagnosis in most cases. Operative intervention is warranted when massive hemorrhage, perforation, or peritonitis complicate the clinical scenario or medical therapy fails to control the disease. We sought to review the management challenges of TM and its possible management strategies in this article.

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Section: Epidemiologymentioning

confidence: 99%

<p>Toxic Megacolon: Background, Pathophysiology, Management Challenges and Solutions</p>

Desai¹,

Elnaggar²,

Hanfy³

et al. 2020

CEG

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“…Clinical presentation ranges drastically from mild symptomatic states to fulminant toxic colitis Fig. 1 Multiple colon perforation with mesh-like appearance in a child with unknown etiology [27]. In some cases, bowel-wall thickening in imaging and histological changes of collagenous colitis are the only diagnostic clue [27,28].…”

Section: Discussionmentioning

confidence: 99%

“…1 Multiple colon perforation with mesh-like appearance in a child with unknown etiology [27]. In some cases, bowel-wall thickening in imaging and histological changes of collagenous colitis are the only diagnostic clue [27,28]. All 5 patients had pathology reports which confirmed colitis, but the specific type of colitis was not revealed [29].…”

Section: Discussionmentioning

confidence: 99%

Etiology and surgical management of pediatric acute colon perforation beyond the neonatal stage

Tan¹,

Wang²,

Pang³

et al. 2021

BMC Surg

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Purpose Acute colon perforation is a pediatric surgical emergency. We aimed to analyze the different etiologies and clinical characteristics of acute non-traumatic colon perforation beyond the neonatal period and to identify surgical management and outcomes. Methods This retrospective study included 18 patients admitted with acute colon perforation and who received surgical treatment. Results Age of patients ranged between 1 month and 15 years. Five patients swallowed foreign objects (two swallowed magnets), two had colon perforation secondary to a malignant tumor (both colorectal adenocarcinoma) and two were iatrogenic (one prior colonoscopy, one air enema for intussusception). There was one perforation due to chemotherapy and Amyand’s hernia respectively. The remaining seven patients had unknown etiologies; five of them were diagnosed with colitis. Fifteen (83.3 %) patients underwent open laparotomy, among which four attempted laparoscopy first. Three (16.7 %) patients underwent laparoscopic surgery. Fourteen (77.8 %) patients received simple suture repairs and four (22.2 %) received colonic resections and anastomosis. Four (22.2 %) patients received a protective diverting colostomy and three (16.7 %) received an ileostomy. Conclusions There is a wide range of etiology besides necrotizing enterocolitis and trauma, but a significant portion of children present with unknown etiology. Type of surgery elected should be dependent on the patient’s etiology, disease severity and experience of surgeons.

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“…Colovesical fistula present with free air in the bladder with thickening of the adjacent bladder wall [30]. Several episodes of treatment-resistant lower urinary tract infection and the presence of stool or air in the urine are the common symptoms in these patients.…”

Section: Complications Of Diverticulitismentioning

confidence: 99%

Diverticulitis: a comprehensive review with usual and unusual complications

et al. 2016

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Diverticulitis is characterized by inflammation of the outpouchings of the bowel wall. Imaging findings of diverticulitis include edematous thickening of the bowel wall with inflammatory changes within the adjacent mesenteric fat. Uncomplicated diverticulitis can be treated conservatively; however, complicated diverticulitis may not be responsive to medical treatment and life-threatening conditions may occur. In this review, we aimed to illustrate the ultrasonography (US) and computed tomography (CT) features of diverticulitis and its complications including perforation, phlegmon, abscess, ascending septic thrombophlebitis (phylephlebitis), bleeding, intestinal obstruction, and fistula.Teaching Points• Complications of diverticulitis may be highly variable. • It may be difficult to diagnose diverticulitis as underlying cause of severe complications. • MDCT is essential for the primary diagnosis of the acute diverticulitis and its complications.

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Colorectal Emergencies and Related Complications: A Comprehensive Imaging Review—Imaging of Colitis and Complications

Abstract: This review focuses on imaging features of the spectrum of colitides and the complications related to colitides.

Cited by 23 publications

References 49 publications

<p>Toxic Megacolon: Background, Pathophysiology, Management Challenges and Solutions</p>

<p>Toxic Megacolon: Background, Pathophysiology, Management Challenges and Solutions</p>

Etiology and surgical management of pediatric acute colon perforation beyond the neonatal stage

Diverticulitis: a comprehensive review with usual and unusual complications

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