Ulcerative colitis: a tenth developed toxic megacolon.

Clinical bottom line (level 4)

  1. A tenth of patients with severe acute ulcerative colitis developed toxic megacolon.
Caprilli et al: Journal of Clinical Gastroenterology 1987; 9 (2): 160-164
Expires May 2003

The study

Prospective cohort study with unblinded, unobjective outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: university hospital, Italy

69 patients (aged ?, ?% male) severe acute ulcerative colitis

Excluded if
  • presented with toxic megacolon, perforation, or massive bleeding


    • All patients had prednisolone 40 mg po once daily and fluid replacement. Patients taking sulphasalazine before admission continued it. Patients with toxic megacolon had total parenteral nutrition, iv hydrocortisone and nil-by-mouth.


    Outcomes studied:
  • toxic megacolon

    • The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)
    toxic megacolon ? 7/69 10%
    (3.0% to 17%)

    • No factors were found to clearly increase the risk of toxic megacolon.

    Citation

    1. Caprilli R, Vernia P, Latella G, et al: Early recognition of toxic megacolon. Journal of Clinical Gastroenterology 1987; 9 (2): 160-164
    Search Terms: reference from review article
    Contributor: Chris Ball and Clare Wotton, November 2000
    Reviewer:

    Clinical Question.
    Patient severe acute ulcerative colitis
    Intervention or Exposure prevalence
    Outcome toxic megacolon