Abstract
Marked dilation of the colon to a threshold diameter above which there is risk of colonic perforation is termed megacolon. In this chapter, we will not be considering “toxic megacolon,” which is an acute dilation of the colon associated with colitis. Acute megacolon can occur either secondary to an acute obstructive process or with no evidence for a mechanical origin. Different studies have described the risk of perforation of the cecum in acute megacolon. During acute dilation, the risk of ischemic changes with subsequent cecal perforation rises with diameter of the cecum ranging from > 9 cm to > 12 cm. Colonic ischemia has been reported in up to 10% of patients with acute colonic distention.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Ogilvie WH. Large intestine colic due to sympathetic deprivation: a new clinical syndrome. BMJ, 2 (1948) 671–673.
Dudley HA, Sinclair IS, McLaren IF, McNair TJ, Newsam JE. Intestinal pseudo-obstruction. J. R. Coll. Surg. Edinb., 3 (1958) 206–217.
Harari D, Minaker KL. Megacolon in patients with chronic spinal cord injury. Spinal Cord, 38 (2000) 331–339.
O’Malley KJ, Flechner SM, Kapoor A, et al. Acute colonic pseudo-obstruction (Ogilvie’s syndrome) after renal transplantation. Am. J. Surg., 177 (1999) 492–496.
Ballaro, A, Gibbons CLM, Murray DM, Kettlewell MGW, Benson MK. Acute colonic pseudo-obstruction after total hip replacement. J. Bone Joint Surg., 79 (1997) 621–623.
Wright, R. Lactulose-induced megacolon. Gastrointest. Endosc., 34 (1988) 489–490.
Stieger DS, Cantieni R, Frutiger A. Acute colonic pseudo-obstruction (Ogilvie’s syndrome) in two patients receiving high dose clonidine for delirium tremens. Intensive Care Med. 23 (1997) 780–782.
Sood A, Kumar R. Imipramine induced acute colonic pseudo-obstruction (Ogilvie’s syndrome): a report of two cases. Indian J. Gastroenterol., 15 (1996) 70–71.
Ohri SK, Patel T, Desa CBL, Spencer J. Drug-induced colonic pseudo-obstruction. Dis. Colon Rectum, 34 (1991) 346–350.
Post AB, Falk GW, Bukowski RM. Acute colonic pseudo-obstruction associated with interleukin-2 therapy. Am. J. Gastroenterol., 86 (1991) 1539–1541.
Walsh TN and Lane D. Pseudo-obstruction of the colon associated with varicella-zoster infection. Ir. J. Med. Sci., 151 (1982) 318–319.
Low VHS. Colonic pseudo-obstruction: Value of prone lateral view of the rectum. Abdom. Imaging, 20 (1995) 531–533.
Sloyer AF, Panella VS, Demas BE, et al. Ogilvie’ s syndrome: Successful management without colonoscopy. Dig. Dis. Sci., 33 (1988) 1391–1396.
Bonacini M, Smith OJ, Pritchard T. Erythromycin as therapy for acute colonic pseudo-obstruction (Ogilvie’s syndrome). J. Clin. Gastroenterol., 13 (1991) 475–487.
Snape WJ Jr, Carlson GM, Cohen S. Human colonic myoelectric activity in response to prostigmin and the gastrointestinal hormones. Dig. Dis., 22 (1977) 881–887.
Stephenson BM, Morgan AR, Salaman JR, Wheeler MH. Ogilvie’s syndrome: A new approach to an old problem. Dis. Colon Rectum, 38 (1995) 424–427.
Turegano-Fuentes F, Munoz-Jimenez F, DelValle-Hernandez E, et al. Early resolution of Ogilvie’s syndrome with intravenous neostigmine. Dis. Colon Rectum, 40 (1997) 1353–1357.
Pones RJ, Saunders MD, Kimmey MB. Neostigmine for the treatment of acute colonic pseudo-obstruction. N. Eng. J. Med., 341 (1999) 137–141.
Kukora JS, Dent TL, Thomas L. Colonoscopie decompression of massive nonobstructive cecal dilation. Arch. Surg., 112 (1977) 512–517.
Harig JM, Fumo DE, Loo FD, et al. Treatment of acute nontoxic megacolon during colonoscopy: tube placement verses simple decompression. Gastrointest. Endosc., 34 (1987) 23–27.
Fiorito LI, Schoen RE, Brandt LJ. Pseudo-obstruction associated with colonic ischemia: successful management with colonoscopic decompression. Am. J. Gastroenterol., 86 (1991) 1472–1476.
Jetmore AB, Timmcke AE, Gathright JB, Hicks TC, Ray JE, Baker JW. Ogilvie’s syndrome: colonoscopic decompression and analysis of predisposing factors. Dis. Colon Rectum, 35 (1992) 1135–1142.
Geller A, Petersen BT, Gostout C. Endoscopie decompression for acute colonic pseudo-obstruction. Gastrointest. Endosc., 44 (1996) 144–150.
Estela CM, Burd DAR. Conservative management of acute pseudo-obstruction in a major burn. Burns, 25 (1999) 523–525.
Duh QY, Way LW. Diagnostic laparoscopy and laparoscopie cecostomy for colonic pseudo-obstruction. Dis. Colon Rectum, 36 (1993) 65–70.
Vaughn P, Schlinkert RT. Management of cecal perforation secondary to Ogilvie’ s syndrome by laparoscopie tube cecostomy. J. Laparoendosc. Surg., 5 (1995) 339–341.
Preston DM, Lennard-Jones JE, Thomas BM. Towards a radiologie definition of idiopathic megacolon. Gastrointest. Radiol., 10 (1985) 167–169.
Kantor JL. A clinical study of some common anatomical abnormalities of the colon. I. The redundant colon. Am. J. Roentenol., 12 (1924) 414–430.
von der Ohe MR, Camilleri M, Carryer PW. A patient with localized megacolon and intractable constipation: Evidence for impairment of colonic muscle tone. Am. J. Gastroenterol., 89 (1994) 1867–1870.
Feinstat T, Tesluk H, Schuffler MD, et al. Megacolon and neurofibromatosis: A neuronal intestinal dysplasia. Gastroenterology, 86 (1984) 1573–1579.
Sonnenberg A, Tsou VT, Muller AD. The “institutional colon”: a frequent colonic dysmotility in psychiatric and neurologic disease. Am. J. Gastroenterol., 89 (1994) 62–66.
Koch TR, Schulte-Bockholt A, Telford GL, Otterson MF, Murad TM, Stryker SJ. Acquired megacolon is associated with alteration of vasoactive intestinal peptide levels and acetylcholinesterase activity. Regul. Pept., 48 (1993) 309–319.
Koch TR, Schulte-Bockholt A, Otterson MF, et al. Decreased vasoactive intestinal peptide levels and glutathione depletion in acquired megacolon. Dig. Dis. Sci., 41 (1996) 1409–1416.
Hagger R, Finlayson C, Kahn F, DeOliveira R, Chimelli L, Kumar D. A deficiency of interstitial cells of Cajal in Chagasic megacolon. J. Auton. Nerv. Syst., 80 (2000) 108–111.
Koch TR, Otterson MF, Telford GL. Nitric oxide production is diminished in colonic circular muscle from acquired megacolon. Dis. Colon Rectum, 43 (2000) 821–828.
Aoki N, Tomita R, Nogai N, Munekata K, Kurose Y, Morita K. Peristaltic reflex and peptidergic nerve control in megacolon. Nippon Heikatsukin Gakkai Zasshi, 25 (1989) 233–235.
Barcia SB, Oliveira JSM, Pinto LZ, Mucillo G, Zucoloto S. The relationship between megacolon and carcinoma of the colon: an experimental approach. Carcinogenesis, 17 (1996) 1777–1779.
Belliveau P, Goldberg SM, Rothenberger DA, Nivatvongs S. Idiopathic acquired megacolon: the value of subtotal colectomy. Dis. Colon Rectum, 25 (1982) 118–121.
Ballantyne G. Review of sigmoid volvulus-Clinical patterns and pathogenesis. Dis. Colon Rectum, 25 (1982) 823–830.
Schagen Van Leeuwen JH. Sigmoid volvulus in a West African population. Dis. Colon Rectum, 28 (1985) 712–716.
Asbun HJ, Castellanos H, Balderrama B, et al. Sigmoid volvulus in the high altitude of the Andes: review of 230 cases. Dis. Colon Rectum, 35 (1992) 350–353.
Fenton-Lee D, Ywo BW, Jones RF, Engel S. Colonic volvulus in the spinal cord injured patient. Paraplegia, 31 (1993) 393–397.
Sarioglu A, Tanyel CH, Buyukpamukcu N, Hisconmez A. Colonic volvulus: a rare presentation of Hirschsprung’s disease. J. Pediatr. Surg., (1997) 32 117–118.
Perry EG. Intestinal volvulus: a new concept. Aust. NZ J. Surg., 53 (1983) 483–486.
Yaseen ZH, Watson RE, Hean HA, Wilson ME. Case report: transverse colon volvulus in a patient with Clostridium difficile pseudomembranous colitis. Am. J. Med. Sci., 308 (1994) 147–150.
Riobo P, Turbi C, Banet R, et al. Colonic volvulus and ulcerative jejunoileitis due to occult Celiac sprue. Am. J. Med. Sci. (1998) 315 317–318.
Plorde JJ, Raker EJ. Transverse colon volvulus and associated Chilaiditi’ s syndrome: case report and literature review. Am. J. Gastroenterol., 91 (1996) 2613–2616.
John H, Gyr T, Giudici G, Martinol S, Marx A. Cecal volvulus in pregnancy. Case report and review of literature. Arch. Gynecol. Obstet., 258 (1996) 161–164.
Montes H, Wolf J. Cecal volvulus in pregnancy. Am. J. Gastroenterol., 94 (1999) 2554–2555.
Burrell HC, Baker DM, Wardrop P, Evans AJ. Significant plain film findings in sigmoid volvulus. Clin. Radiol., 49 (1994) 317–319.
Javors BR, Baker SR, Miller JA. The northern exposure sign: A newly described finding in sigmoid volvulus. Am. J. Roentgenol., 173 (1999) 571–574.
Ballantyne GH, Brandner MD, Beart RW, Ilstrup DM. Volvulus of the colon. Ann. Surg., 202 (1985) 83–92.
Ryan P. Sigmoid volvulus with and without megacolon. Dis. Colon Rectum, 25 (1982) 673–679.
Friedman JD, Odland MD, Bubrick MP. Experience with colonic volvulus. Dis. Colon Rectum, 32 (1989) 409–416.
O’Mara CS, Wilson TH Jr, Stonesifer GL, Cameron JL. Cecal volvulus: analysis of 50 patients with long-term follow-up. Curr. Surg., (1980) 37 132–136.
Chung YF, Eu KW, Nyam DC, Leong AF, Ho YH, Seow-Choen F. Minimizing recurrence after sigmoid volvulus. Br. J. Surg., 86 (1999) 966–967.
Grossmann EM, Longo WE, Stratton MD, Virgo KS, Johnson FE. Sigmoid volvulus in department of veterans medical centers. Dis. Colon Rectum, 43 (2000) 414–418.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2003 Humana Press Inc., Totowa, NJ
About this chapter
Cite this chapter
Stauffer, M., Koch, T.R. (2003). Acute Megacolon, Acquired Megacolon, and Volvulus. In: Koch, T.R. (eds) Colonic Diseases. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-314-9_24
Download citation
DOI: https://doi.org/10.1007/978-1-59259-314-9_24
Publisher Name: Humana Press, Totowa, NJ
Print ISBN: 978-1-4684-9740-3
Online ISBN: 978-1-59259-314-9
eBook Packages: Springer Book Archive