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Acute fulminant ulcerative colitis with toxic megacolon
C Igarashi1, T Hori, M Yoshida
1Department of Pediatrics, Kushiro City General Hospital, Japan.
Insights
A severe case of ulcerative colitis (UC) in an 11-year-old boy was successfully treated non-surgically. Intensive medical therapy led to complete recovery, avoiding the need for surgery.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Colorectal Surgery
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- Fulminant UC presents with severe systemic symptoms and requires urgent management.
- Toxic megacolon is a life-threatening complication of UC.
Observation:
- An 11-year-old male presented with acute fulminant ulcerative colitis.
- Symptoms included systemic deterioration, frequent diarrhea, and lethargy.
- Diagnosis was confirmed by rectal endoscopy and biopsy, revealing toxic megacolon.
Findings:
- The patient received intensive intravenous prednisolone therapy.
- Total parenteral nutrition was administered to support nutritional status.
- Complete clinical recovery was achieved without surgical intervention.
Implications:
- Non-surgical management can be effective in pediatric fulminant UC with toxic megacolon.
- Early and aggressive medical treatment may prevent the need for colectomy.
- This case highlights successful conservative management strategies for severe pediatric ulcerative colitis.
Abstract:
An 11-year-old boy with acute fulminant ulcerative colitis (UC) is presented. He had systemic deterioration with frequent diarrhea and lethargy. Acute fulminant UC associated with toxic megacolon was diagnosed by rectal endoscopy and biopsied specimen. He was treated with intensive intravenous administration of prednisolone and total parenteral nutrition. He recovered completely without any surgical intervention.