HTHSCI 2F03 Lecture Notes - Lecture 14: Erythema Nodosum, Toxic Megacolon, Megaloblastic Anemia

• School: McMaster University
• Department: Health Sciences
• Course: HTHSCI 2F03
• Professor: Bruce Wainman

Document Summary

Fever, malaise, anorexia, wt. loss in active disease. Crc in 15% c pancolitis for 20yrs. Toxic megacolon and ca may occur (< cf. Rcts show no benefit of abx: not routinely recommended. Switch to oral pred + a 5-asa. On day 3: stool freq >8 or crp >45. Predicts 85% chance of needing a colectomy during the admission. Medical: ciclosporin, infliximab or visilizumab (anti-t cell) 1st line: 5-asas po sulfasalazine or mesalazine. Topical rx may be used in proctitis. 30% c colitis require surgery w/i 5yrs. Total / subtotal colectomy c end ileostomy mucus fistula. Completion proctectomy + ileal-pouch anal anastomosis (ipaa) or end ileostomy. Acute colitis op mortality: 7% (30% if perforated) Cdt: c. diff may complicate or mimic. Hydrocortisone: iv + pr if rectal disease. Liquid prep of amino acids, glucose and fatty acids. 50-80% need 1 operation in their life. Defunction distal disease c temporary loop ileostomy. True = composed of complete wall (e. g. meckel"s)