Idiopathic Megacolon—Short Review

Introduction: Idiopathic megacolon (IM) is a rare condition with a more or less known etiology, which involves management challenges, especially therapeutic, and both gastroenterology and surgery services. With insufficiently drawn out protocols, but with occasionally formidable complications, the c...

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Autores principales:	Adrian Constantin, Florin Achim, Dan Spinu, Bogdan Socea, Dragos Predescu
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	idiopathic megacolon etiopathogenic theories of idiopathic megacolon surgical treatment Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/7146f234d0104554b66ba995c2d6c411
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spelling	oai:doaj.org-article:7146f234d0104554b66ba995c2d6c4112021-11-25T17:21:43ZIdiopathic Megacolon—Short Review10.3390/diagnostics111121122075-4418https://doaj.org/article/7146f234d0104554b66ba995c2d6c4112021-11-01T00:00:00Zhttps://www.mdpi.com/2075-4418/11/11/2112https://doaj.org/toc/2075-4418Introduction: Idiopathic megacolon (IM) is a rare condition with a more or less known etiology, which involves management challenges, especially therapeutic, and both gastroenterology and surgery services. With insufficiently drawn out protocols, but with occasionally formidable complications, the condition management can be difficult for any general surgery team, either as a failure of drug therapy (in the context of a known case, initially managed by a gastroenterologist) or as a surgical emergency (in which the diagnostic surprise leads additional difficulties to the tactical decision), when the speed imposed by the severity of the case can lead to inadequate strategies, with possibly critical consequences. Method: With such a motivation, and having available experience limited by the small number of cases (described by all medical teams concerned with this pathology), the revision of the literature with the update of management landmarks from the surgical perspective of the pathology appears as justified by this article. Results: If the diagnosis of megacolon is made relatively easily by imaging the colorectal dilation (which is associated with initial and/or consecutive clinical aspects), the establishing of the diagnosis of idiopathic megacolon is based in practice almost exclusively on a principle of exclusion, and after evaluating the absence of some known causes that can lead to the occurrence of these anatomic and clinical changes, mimetically, clinically, and paraclinically, with IM (intramural aganglionosis, distal obstructions, intoxications, etc.). If the etiopathogenic theories, based on an increase in the performance of the arsenal of investigations of the disease, have registered a continuous improvement and an increase of objectivity, unfortunately, the curative surgical treatment options still revolve around the same resection techniques. Moreover, the possibility of developing a form of etiopathogenic treatment seems as remote as ever.Adrian ConstantinFlorin AchimDan SpinuBogdan SoceaDragos PredescuMDPI AGarticleidiopathic megacolonetiopathogenic theories of idiopathic megacolonsurgical treatmentMedicine (General)R5-920ENDiagnostics, Vol 11, Iss 2112, p 2112 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	idiopathic megacolon etiopathogenic theories of idiopathic megacolon surgical treatment Medicine (General) R5-920
spellingShingle	idiopathic megacolon etiopathogenic theories of idiopathic megacolon surgical treatment Medicine (General) R5-920 Adrian Constantin Florin Achim Dan Spinu Bogdan Socea Dragos Predescu Idiopathic Megacolon—Short Review
description	Introduction: Idiopathic megacolon (IM) is a rare condition with a more or less known etiology, which involves management challenges, especially therapeutic, and both gastroenterology and surgery services. With insufficiently drawn out protocols, but with occasionally formidable complications, the condition management can be difficult for any general surgery team, either as a failure of drug therapy (in the context of a known case, initially managed by a gastroenterologist) or as a surgical emergency (in which the diagnostic surprise leads additional difficulties to the tactical decision), when the speed imposed by the severity of the case can lead to inadequate strategies, with possibly critical consequences. Method: With such a motivation, and having available experience limited by the small number of cases (described by all medical teams concerned with this pathology), the revision of the literature with the update of management landmarks from the surgical perspective of the pathology appears as justified by this article. Results: If the diagnosis of megacolon is made relatively easily by imaging the colorectal dilation (which is associated with initial and/or consecutive clinical aspects), the establishing of the diagnosis of idiopathic megacolon is based in practice almost exclusively on a principle of exclusion, and after evaluating the absence of some known causes that can lead to the occurrence of these anatomic and clinical changes, mimetically, clinically, and paraclinically, with IM (intramural aganglionosis, distal obstructions, intoxications, etc.). If the etiopathogenic theories, based on an increase in the performance of the arsenal of investigations of the disease, have registered a continuous improvement and an increase of objectivity, unfortunately, the curative surgical treatment options still revolve around the same resection techniques. Moreover, the possibility of developing a form of etiopathogenic treatment seems as remote as ever.
format	article
author	Adrian Constantin Florin Achim Dan Spinu Bogdan Socea Dragos Predescu
author_facet	Adrian Constantin Florin Achim Dan Spinu Bogdan Socea Dragos Predescu
author_sort	Adrian Constantin
title	Idiopathic Megacolon—Short Review
title_short	Idiopathic Megacolon—Short Review
title_full	Idiopathic Megacolon—Short Review
title_fullStr	Idiopathic Megacolon—Short Review
title_full_unstemmed	Idiopathic Megacolon—Short Review
title_sort	idiopathic megacolon—short review
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/7146f234d0104554b66ba995c2d6c411
work_keys_str_mv	AT adrianconstantin idiopathicmegacolonshortreview AT florinachim idiopathicmegacolonshortreview AT danspinu idiopathicmegacolonshortreview AT bogdansocea idiopathicmegacolonshortreview AT dragospredescu idiopathicmegacolonshortreview
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Idiopathic Megacolon—Short Review

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