
http://revistamedica.imss.gob.mx/editorial/index.php/revista_medica/article/view/62/1614
写真は、巨大結腸症の手術例です。
この写真とは、関係ありませんが、
便秘の治療のために、高FODMAPのラクツロースを服用し、
大量のガスによって巨大結腸症を引き起こし、死亡したという報告があります。
Ned
Tijdschr Geneeskd. 2004 May 15;148(20):998-1001.
Megacolon during treatment
with lactulose
van der Vliet HJ, van Bodegraven AA.
Abstract
Two female
patients aged 88 and 82 who were being treated for constipation with lactulose,
developed life-threatening dilatation of the bowel. Both underwent surgery. One
of them was found to have cancer of the bowel; she had an uneventful
postoperative recovery. No mechanical abnormalities were found in the second
patient but she died due to respiratory insufficiency following aspiration.
Lactulose is one of the most frequently prescribed laxatives. In the colon it
is metabolized by bacteria into short-chain fatty acids, hydrogen and carbon
dioxide. The resulting production of gas in the colon can contribute
to a non-toxic megacolon, particularly in patients with delayed intestinal
passage.
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