Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- febre/calafrios
- taquicardia
- alterações do estado mental
- hipotensão
- distensão abdominal
Other diagnostic factors
- diarreia
- dor abdominal
- desconforto abdominal
Risk factors
- colite ulcerativa
- Colite de Crohn
- colite pseudomembranosa
- colite infecciosa
- vírus da imunodeficiência humana (HIV)/síndrome de imunodeficiência adquirida (AIDS)/imunossupressão
- descontinuação de medicamentos para tratamento da doença inflamatória intestinal
- agentes antimotilidade
- imunossupressão quimioterápica/química
- anormalidades eletrolíticas
Diagnostic investigations
1st investigations to order
- Hemograma completo
- eletrólitos séricos
- níveis de albumina sérica
- ácido lático sérico
- estudos de fezes
- tomografia computadorizada (TC) de abdome/pelve
- radiografia abdominal
- radiografia torácica
Investigations to consider
- proteína C-reativa
- velocidade de hemossedimentação (VHS)
- hemoculturas
- sigmoidoscopia
- biópsia retal
- espécime cirúrgico
Treatment algorithm
todos os pacientes
Contributors
Authors
Jan Rakinic, MD
Chief
Colorectal Surgery
Department of Surgery
Southern Illinois University School of Medicine
Springfield
IL
Disclosures
JR is the President of the American Board of Colon and Rectal Surgery.
V. Prasad Poola, MBBS, FACS, FASCRS
Associate Professor of Surgery
Department of Surgery
Southern Illinois University School of Medicine
Springfield
IL
Divulgaciones
VPP declares that he has no competing interests.
Agradecimientos
Dr Jan Rakinic and Dr V. Prasad Poola would like to gratefully acknowledge Dr Scott A. Strong, Dr Mukta V. Krane, and Dr Alessandro Fichera, previous contributors to this topic.
Divulgaciones
SAS, MVK, and AF declare that they have no competing interests.
Revisores por pares
Sharon Stein, MD
Assistant Professor of Surgery
Division of Colon and Rectal Surgery
University Hospital Case Medical Center
Cleveland
OH
Divulgaciones
SS received a fee for educational courses on laparoscopic surgery, paid for in part by Covidien, Olympus, and Applied Medical.
David J. Hackam, MD, PhD
Associate Professor of Pediatric Surgery
University of Pittsburgh School of Medicine
Pittsburgh
PA
Divulgaciones
DJH declares that he has no competing interests.
James Wheeler, MB, BCh, MD, FRCS
Consultant
Colorectal Surgeon
Addenbrookes Hospital
Cambridge
UK
Divulgaciones
JW declares that he has no competing interests.
Referencias
Artículos principales
Rubin DT, Ananthakrishnan AN, Siegel CA, et al. ACG clinical guideline: ulcerative colitis in adults. Am J Gastroenterol. 2019 Mar;114(3):384-413.Texto completo Resumen
McDonald LC, Gerding DN, Johnson S, et al. Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018 Mar 19;66(7):987-94.Texto completo Resumen
Kelly CR, Fischer M, Allegretti JR, et al. ACG clinical guidelines: prevention, diagnosis, and treatment of Clostridioides difficile infections. Am J Gastroenterol. 2021 Jun 1;116(6):1124-47.Texto completo Resumen
Lightner AL, Vogel JD, Carmichael JC, et al. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the surgical management of Crohn's disease. Dis Colon Rectum. 2020 Aug;63(8):1028-52.Texto completo Resumen
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