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Published on: December 8, 2014
[Toxic Megacolon: A rare complication of chronic constipation. Three Pediatric Cases]
Macarena Muñoz P1, Fernanda Andueza A1, Marcela Santos M1
1Hospital Exequiel González Cortés, Universidad de Chile, Santiago, Chile.
Insights
Untreated chronic constipation in children can lead to toxic megacolon, a severe condition. Prompt medical and surgical care is crucial for favorable outcomes in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Colorectal Surgery
Background:
- Chronic constipation significantly impacts pediatric quality of life.
- Poor treatment adherence exacerbates constipation, increasing complication risks.
- Toxic megacolon is a life-threatening complication of untreated chronic constipation.
Purpose of the Study:
- To present three pediatric cases of toxic megacolon.
- To highlight toxic megacolon as a complication of poorly managed chronic constipation.
Main Methods:
- Case series of three male patients (6-13 years old) with chronic constipation and poor adherence.
- Patients presented with toxic megacolon symptoms, requiring critical care and ostomy.
- Organic causes of constipation were excluded in all cases.
Main Results:
- All three patients required critical care unit admission and surgical ostomy.
- Favorable outcomes were achieved, with stoma reversal surgery performed 8-24 months later.
- No underlying organic cause for constipation was identified.
Conclusions:
- Toxic megacolon is a rare but severe complication of pediatric chronic constipation.
- Early recognition and a multidisciplinary medical-surgical approach are essential.
- High index of suspicion is necessary for timely diagnosis and management.
Introduction:
Chronic constipation is a frequent pathology in the pediatric age that affects the quality of life of pa tients and their families. Its management is usually complex and long associated with poor adheren ce. Toxic megacolon is a serious, potentially lethal disease when chronic constipation is left untreated or poor adherence to treatment.
Objective:
To report 3 pediatric cases of toxic megacolon as a com plication of poorly managed chronic constipation.
Clinical Cases:
Three males patients, aged 6 to 13 years, with a history of chronic constipation and poor adherence to treatment are discussed. They were admitted to the emergency department with clinical findings of toxic megacolon (intestinal dilation and signs of systemic toxicity). Given their condition, all patients required management in the critical patient unit (CPU) and early surgical intervention, undergoing ostomy. All presented fa vorable outcome, performing stoma reversal surgery between 8-24 months later. In all cases, organic cause of the constipation was ruled out.
Conclusions:
Toxic megacolon is an infrequent but highly morbid and potentially lethal disease. It requires a high index of suspicion as well as multidisciplinary medical-surgical management.
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