Outcome of emergency surgery for severe neuroleptic-induced colitis: results of a prospective cohort.
Colorectal Dis
; 18(12): 1179-1185, 2016 Dec.
Article
en En
| MEDLINE
| ID: mdl-27166739
ABSTRACT
AIM:
The study evaluated the outcome of severe acute antipsychotic (neuroleptic) drug related colitis requiring emergency surgery.METHOD:
From 2009 to 2014, 20 patients underwent emergency surgery for acute and severe neuroleptic-related ischaemic colitis. Neuroleptic-induced colitis was defined as another cause besides inflammatory, infectious or ischaemic colitis with a relationship to treatment by antipsychotic drugs.RESULTS:
The main drugs involved were cyamemazine (n = 9, 45%), loxapine (n = 5, 25%), haloperidol (n = 4, 20%) and alimemazine (n = 4, 20%). Most (n = 14, 70%) patients presented with haemodynamic instability requiring massive resuscitation and vasopressive drugs. CT signs of digestive impairment were found in 13 (65%) patients having emergency surgery. The lesions were pancolonic in 40%; transparietal necrosis was found in 45% and 15% had colonic perforation. Twelve (60%) patients had total or subtotal colectomy and eight (40%) a segmental colectomy with colostomy or ileostomy in all cases. The postoperative mortality was 15% and morbidity was 70%, necessitating surgical reintervention in two (10%) patients. Of the 17 surviving patients, 11 (64.7%) had restoration of intestinal continuity after a median delay of 103 days, with a postoperative morbidity rate of 36.3%. In the intent-to-treat population, the permanent stoma rate was 30%.CONCLUSION:
The morbidity and mortality of surgery for neuroleptic-drug-induced colitis is higher than for colitis due to other causes. A better knowledge of this condition should lead to early diagnosis.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Antipsicóticos
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Colostomía
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Ileostomía
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Colitis Isquémica
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Tratamiento de Urgencia
Tipo de estudio:
Etiology_studies
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Observational_studies
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Screening_studies
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Colorectal Dis
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2016
Tipo del documento:
Article
País de afiliación:
Francia