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Lethal obstructive colitis: how and when patients with colonic obstruction should be prevented from falling into a
Yoshihiro Moriwaki1, Mitsugi Sugiyama, Hiroshi Toyoda
1Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, Japan. qqc3@urahp.yokohama-cu.ac.jp
Hepato-Gastroenterology
|July 23, 2009
Summary
Lethal obstructive colitis (LOC) is a severe condition requiring rapid surgical intervention. Early diagnosis and prompt surgery are crucial for improving patient survival rates in cases of obstructive colitis with shock.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Critical Care Medicine
Background:
- Lethal obstructive colitis (LOC) is defined as obstructive colitis with severe or septic shock.
- This condition presents a significant challenge in diagnosis and management.
Purpose of the Study:
- To clarify the pathological condition of LOC.
- To define effective treatment strategies for LOC.
Main Methods:
- Retrospective analysis of 5 patients diagnosed with LOC.
- Evaluation of pathophysiology and management strategies from medical records.
- Included causes: colorectal cancer, fecal impaction, and volvulus.
Main Results:
- Emergency operations were performed rapidly (within 150 minutes).
- Survival rates were 3/5, with 2 deaths.
- Hemodynamic instability (low systolic pressure) was present in all patients, but pulse rate, consciousness, and cardiac events (ventricular tachycardia) differed between survivors and non-survivors.
Conclusions:
- Awareness of LOC as a potentially lethal disease is essential for colonic obstruction management.
- Early diagnosis and aggressive surgical treatment are critical for improving outcomes.
- Prompt surgical intervention before the onset of shock is paramount.
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