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Related Concept Videos

Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

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Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
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Inflammatory Bowel Disease IV: Clinical Manifestations01:20

Inflammatory Bowel Disease IV: Clinical Manifestations

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Inflammatory bowel disease (IBD) encompasses two major chronic disorders—ulcerative colitis and Crohn’s disease—each characterized by relapsing episodes of gastrointestinal inflammation. Although they share certain clinical features, their patterns of involvement and manifestations differ in ways that aid diagnosis and guide management.Ulcerative ColitisUlcerative colitis is limited to the colon and rectum and involves continuous inflammation of the mucosal layer. The...
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Acute Pancreatitis II: Pathophysiology01:21

Acute Pancreatitis II: Pathophysiology

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The pathophysiology of acute pancreatitis centers on injury to pancreatic acinar cells, which initiates a cascade of harmful intracellular events.This injury leads to premature activation of trypsinogen to trypsin in the pancreas. Trypsin then activates other digestive enzymes, such as chymotrypsin, elastase, and phospholipase A2, which begin breaking down pancreatic tissue. The resulting autodigestion causes local inflammation, tissue swelling, hemorrhage, and fat necrosis.Injured acinar cells...
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Acute Pancreatitis I: Introduction01:25

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Acute pancreatitis is the sudden inflammation of the pancreas caused by the early activation of digestive enzymes, leading to the autodigestion of pancreatic tissue. This results in local inflammation and, in severe cases, systemic complications.EtiologyUnderstanding the underlying causes is crucial, as identifying the etiology guides treatment and anticipates complications. Acute pancreatitis can be triggered by various factors, typically grouped into the following clinical categories.Biliary...
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Acute Pancreatitis I: Introduction01:27

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Pancreatitis is inflammation of the pancreas, an organ located behind the stomach. It can be either acute or chronic.
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
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Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

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Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
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Murine Colitis Modeling using Dextran Sulfate Sodium DSS
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[Severe acute colitis: two fatal cases in Dakar].

D Dia1, M C Cisse1, G Diouf1

  • 1Hépato-gastro-entérologie, hôpital général de Grand-Yoff, Dakar, Sénégal.

Medecine Et Sante Tropicales
|October 9, 2014
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Summary

Severe acute colitis (SAC), a life-threatening complication of ulcerative colitis (UC), is rarely reported in sub-Saharan Africa. This report details two fatal SAC cases in Senegalese patients, highlighting diagnostic challenges in endemic infectious colitis regions.

Keywords:
Senegalacute severe colitisulcerative colitis

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Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Public Health

Background:

  • Inflammatory bowel disease (IBD), particularly ulcerative colitis (UC), can lead to severe acute colitis (SAC), a life-threatening condition.
  • IBD is historically considered uncommon in sub-Saharan Africa, with limited data on SAC prevalence and management in this region.

Observation:

  • Two fatal cases of SAC in Senegalese patients with UC are presented, occurring in Dakar.
  • Both patients presented with chronic dysenteric syndrome; initial management with antibiotics for suspected infectious colitis proved ineffective.
  • Despite interventions including parenteral corticosteroids, both patients experienced severe complications, including intestinal perforation and toxic megacolon, leading to fatal outcomes.

Findings:

  • The cases underscore the potential for SAC in UC patients even in regions where IBD is perceived as rare.
  • Delayed or missed diagnosis of SAC, potentially due to the predominance of infectious colitis, contributed to poor outcomes.
  • Treatment challenges included the need to differentiate SAC from infectious colitis and the accessibility of advanced care.

Implications:

  • Clinicians in subtropical regions should maintain a high index of suspicion for SAC in patients with UC, especially those presenting with dysenteric symptoms.
  • Early and appropriate management of SAC is crucial, even amidst diagnostic uncertainty and potential co-existing infections.
  • Improved diagnostic capabilities and timely therapeutic interventions are essential for reducing mortality associated with SAC in underserved regions.