{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,3]],"date-time":"2022-04-03T08:54:43Z","timestamp":1648976083627},"reference-count":7,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2013,8,2]],"date-time":"2013-08-02T00:00:00Z","timestamp":1375401600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinics and Practice"],"abstract":"<jats:p>Toxic megacolon is a rare and serious complication of Crohn\u2019s disease. Because of the associated high morbidity and mortality, early recognition and management of toxic megacolon is important. Through two cases of toxic megacolon complicating Crohn\u2019s disease, we assessed the clinical, radiologic and therapeutic characteristics of this complication. A 35-year-old man presented a first course of Crohn\u2019s disease treated with corticosteroid. He exhibited sudden severe abdominal pain and distension with shock. A plain abdominal radiography revealed toxic megacolon. He underwent medical therapy, but symptoms not relieved. The patient underwent subtotal colectomy with ileostomy. The resected specimen confirmed the diagnosis. Recovery of digestive continuity was performed. Endoscopic evaluation six months later did not shown recurrence. A 57-year-old man presented with severe acute colitis inaugurating Crohn\u2019s disease, was treated with corticosteroid and antibiotics. He exhibited signs of general peritonitis. Computed tomographic examination revealed toxic megacolon with free perforation, showing prominent dilation of the transverse colon and linear pneumatosis. The patient underwent emergent subtotal colectomy and ileostomy. The final histological patterns were consisting with diagnosis of Crohn\u2019s disease associated with cytomegalovirus infection. The patient underwent antiviral therapy during 15 days. Because of the high risk of postoperative recurrence, he underwent immunosuppressive therapy. Recovery of digestive continuity was performed successfully. Toxic megacolon in Crohn\u2019s disease is a serious turning of this disease. We underscore the importance of early diagnosis of toxic megacolon and rapid surgical intervention if improvement is not observed on medical therapy.<\/jats:p>","DOI":"10.4081\/cp.2013.e24","type":"journal-article","created":{"date-parts":[[2013,9,10]],"date-time":"2013-09-10T20:04:49Z","timestamp":1378843489000},"page":"e24","source":"Crossref","is-referenced-by-count":1,"title":["Toxic Megacolon Complicating a First Course of Crohn\u2019s Disease: About Two Cases"],"prefix":"10.3390","volume":"3","author":[{"given":"Rania","family":"Hefaiedh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariem","family":"Cheikh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rym","family":"Ennaifer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lassad","family":"Gharbi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Najet","family":"Bel Hadj","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2013,8,2]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/S0016-5085(19)36490-X","article-title":"Megacolon a complication of ulcerative colitis","volume":"16","author":"Marshak","year":"1950","journal-title":"Gastroenterology"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1155\/2005\/637419","article-title":"Advances in the diagnosis and management of toxic megacolon","volume":"19","author":"McMullen","year":"2005","journal-title":"Can J Gastroenterol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.clinimag.2011.01.012","article-title":"Toxic megacolon in patients with severe acute colitis: computed tomographic features","volume":"35","author":"Moulin","year":"2011","journal-title":"Clin Imaging"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/S0140-6736(97)10475-5","article-title":"Toxic megacolon","volume":"351","author":"Sheth","year":"1998","journal-title":"Lancet"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/S0016-5085(19)33962-9","article-title":"An experience of ulcerative colitis. 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Toxic dilation in 55 cases","volume":"57","author":"Jalan","year":"1969","journal-title":"Gastroenterology"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/0016-5085(90)90613-6","article-title":"Predictability of the postoperative course of crohn\u2019s disease","volume":"99","author":"Rutgeerts","year":"1990","journal-title":"Gastroenterol"},{"key":"ref7","first-page":"176","article-title":"Toxic megacolon: a review","volume":"10","author":"Sheikh","year":"2003","journal-title":"J K Practitioner"}],"container-title":["Clinics and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-7283\/3\/2\/e24\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T06:23:30Z","timestamp":1644474210000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-7283\/3\/2\/e24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,8,2]]},"references-count":7,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2013,5]]}},"alternative-id":["cp.2013.e24"],"URL":"https:\/\/doi.org\/10.4081\/cp.2013.e24","relation":{},"ISSN":["2039-7283"],"issn-type":[{"value":"2039-7283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,8,2]]}}}