Medical decompression of toxic megacolon by “Rolling”: A new technique of decompression with favorable long-term follow-up

D. H. Present, D. Wolfson, I. M. Gelernt, P. H. Rubin, J. Bauer, M. L. Chapman

Research output: Contribution to journalArticlepeer-review

46 Scopus citations

Abstract

We treated 19 consecutive patients with toxic megacolon complicating inflammatory bowel disease with the usual intensive medical regimen, but also added a new technique, namely, the frequent rolling of the patient to the prone position in order to redistribute colonic gas and thereby promote decompression. In all 19 patients (100%) the colon was decompressed within 1–13 days (mean 4.9 days). Two patients (10.5%) died. In long-term follow-up (mean 6.5 years), only 4 of the 17 survivors (21%) ultimately required colectomy; the remaining 13 (68%) were either completely well or only minimally symptomatic and did not require steroids. Most reports on the management of toxic megacolon stress the need for early surgical intervention, but our success in decompression with the addition of the “rolling technique” suggests an improvement in the nonoperative management of toxic megacolon.

Original languageEnglish
Pages (from-to)485-490
Number of pages6
JournalJournal of Clinical Gastroenterology
Volume10
Issue number5
DOIs
StatePublished - Oct 1988
Externally publishedYes

Keywords

  • Crohn’s colitis
  • Medical management
  • Toxic megacolon
  • Ulcerative colitis

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