Toxic Megacolon: Background, Pathophysiology, Management Challenges and Solutions [Corrigendum]

Desai J, Elnaggar M, Hanfy AA, Doshi R. Clin Exp Gastroenterol. 2020;13:203—210.

The authors wish to add the following reference to the end of the reference section on page 210.

60. UpToDate Inc. Toxic megacolon. Alphen aan den Rijn: Wolters Kluwer; last updated, 2020. Available from: https://www.uptodate.com/contents/toxic-megacolon. Accessed June 28, 2021.

The new reference should have been cited throughout the paper in the following places:

Page 205, left column, second paragraph, first sentence, the text should read “A complete colonoscopy is extremely risky in patients with TM because it can cause colonic perforation.⁶⁰”

Page 205, right column, line 6, the text should read “TPN provides no proven clinical benefit in terms of avoiding surgical intervention in patients with colitis due to UC.^35,60”

Page 205, Glucocorticoids section, third and fourth sentences, the text should read “Dexamethasone, by diminishing the expression of NO synthase, has been reported to decrease the colonic diameter.⁶⁰ Most providers consider methylprednisolone because of its lower potassium wasting and sodium retaining properties, while others prefer prednisolone as the oral and parenteral doses are the same.⁶⁰”

Page 205, Infliximab or Cyclosporine section, first sentence, the text should read “Patients with IBD-related TM who are refractory to three days of intravenous glucocorticoid therapy should receive either Infliximab or Cyclosporine as the secondline therapy.⁶⁰”

Page 205, Infliximab or Cyclosporine section, last sentence, the text should read “Since these three conditions may not be readily distinguishable during an acute flare-up such as TM, many authors suggest treating all IBD-related TM with the same approach.⁶⁰”

Page 206, C. difficile colitis section, third paragraph, first and second sentences, the text should read “Surgery is indicated in patients with colonic perforation, necrosis, or full-thickness ischemia, intraabdominal hypertension or abdominal compartment syndrome, clinical signs of peritonitis, or worsening abdominal exam despite adequate medical therapy, and end-organ failure.⁶⁰ Besides, white blood cell count >50,000 cell/mL and serum lactate level of >5 mmol/L are relative indications for surgical intervention.⁶⁰”

Page 207, Pregnant women section, second sentence, the text should read “Patients who are in remission at the conception are likely to remain in remission during pregnancy.⁶⁰”

Page 208, Prognosis section, first paragraph, last sentence, the text should read “Colonic perforation is associated with a significantly worse prognosis, with the mortality rate increased by three- to fivefold.^6,8,60”

Page 208, Prognosis section, fourth paragraph, first sentence, the text should read “The difference in mortality rates may also be due to the biases of medical or surgical providers.⁶⁰”

Page 208, Prognosis section, fourth paragraph, third sentence, the text should read “Surgical studies reveal up to a 50 percent rate of future surgical intervention, including colectomy in patients with TM who initially responded well to medical treatment alone.^55,58,60”

The authors acknowledge the missing reference as a source of information for their article and apologise for not including it in the original publication.

Read the original article