Colitis is a topic covered in the Pocket ICU Management.

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First Things First (assess & treat for the following)

  • Toxic symptoms suggesting fulminant colitis
    • Severe abdominal pain
    • High fever
    • Marked leukocytosis
    • Altered mental status
    • Hypotension
  • Colonic dilation suggesting toxic megacolon
    • Obtain serial plain films or CT; >7 cm colonic diameter or “thumbprinting”
    • Correct electrolyte abnormalities, especially hypokalemia.
    • Eliminate possible exacerbating factors:
      • Opiates
      • Anticholinergics
      • Antidepressants
      • Antimotility agents
  • Peritoneal findings suggesting perforation
    • Obtain immediate surgical consultation (if not already accomplished).
    • Free perforation is absolute indication for surgery.
  • Infectious etiology
  • Other etiologies in differential diagnosis (ie, “look-alikes”)
    • Ischemic colitis
    • Colonic volvulus
    • Diverticulitis
    • Obstructing colon cancer

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Last updated: April 14, 2010