Could the Complications of Megacolon be Avoided by Monitoring the Risk Patients Cases Report

We report 2 cases of megacolon associated with cerebrovascularaccident and neuropsychiatric drug consumption.Case report 1: a 75-year-old woman with diabetes mellitus,hypertension, tachycardia with atrial fibrillation, bilateralpleural effusions and previous cerebral hemorrhage wasadmitted in our hospital. She presented clouded sensoriumand abdominal distension, with closed alvus. The CT scanshowed a distension of the colon, with severe fecal impaction.A volvulus of the sigma was found at surgical intervention.Case report 2: a 59-year-old man with a medical history ofoligophrenia was admitted to our hospital for acute abdomen.He presented stupor and closed alvus with abdominaldistension. The abdominal CT scan showed a dolichosigma,with fecal impaction. The patient was submitted to a laparotomyand a two millimetres perforation of the sigma was found.The sigma had a diameter of 28 cm and a length of 75 cm.Even if a clear correlation has not been found yet, anomaliesof the regulation of the gastro-intestinal motility can occur atdifferent levels in patients with psychiatric or cerebrovasculardiseases and drug consumption with anticholinergic properties,and they should be carefully monitored. The purpose is an early diagnosis of colon function anomalies in order to avoidpotentially fatal complications

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