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Megacolon is an abnormal dilation of the colon (also called the large intestine). [ 1 ] [ 2 ] This leads to hypertrophy of the colon. [ 2 ] The dilation is often accompanied by a paralysis of the peristaltic movements of the bowel.
Ogilvie syndrome, or acute colonic pseudo-obstruction, is the acute dilatation of the colon in the absence of any mechanical obstruction in severely ill patients. [1]Acute colonic pseudo-obstruction is characterized by massive dilatation of the cecum (diameter > 10 cm) and right colon on abdominal X-ray.
Other symptoms may include vomiting, abdominal pain, diarrhea and slow growth. [1] Most children develop signs and symptoms shortly after birth. However, others may be diagnosed later in infancy or early childhood. [4] [5] About half of all children with Hirschsprung's disease are diagnosed in the first year of life. [4]
Treatment for IPO (acute or chronic) is aimed at removing the disease process and/or managing the complications present. Focus is placed on management of pain, gastrointestinal symptoms, nutritional deficiencies, fluid status, infection control, and improving quality of life.
Complications include toxic megacolon, dehydration and sepsis.Such complications generally occur in young children (< 1 year of age) and immunocompromised people. A chronic course of the disease is possible; this disease process is likely to develop without a distinct acute phase.
It may occur in chronic obstruction of stool transit, as in megacolon [10] and chronic constipation. Some diseases, such as Chagas disease, Hirschsprung's disease and others damage the autonomic nervous system in the colon's mucosa (Auerbach's plexus) and may cause extremely large or "giant" fecalomas, which must be surgically removed ...
However, the histologic appearance varies, and evidence of chronic inflammation is seen in some cases, including intraepithelial lymphocytes or basal lymphocytes and crypt architecture distortion. [4] Histologic inflammation may occur as early as 1–2 weeks after immune checkpoint inhibitor therapy, well before the onset of symptoms. [4]
At any stage, children with chronic illness can have reduced quality of life, especially if the children or their families are of low socioeconomic status. [ 31 ] [ 32 ] Malnutrition is a greater risk among children with chronic illnesses, and children's physical and cognitive development may be poorly impacted, such as abnormal immune system ...