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Abstract：
BACKGROUND: Acquired Megacolon (AMC) is a condition involving persistent dilatation and lengthening of the colon in the absence of organic disease. Diagnosis depends on subjective radiological, endoscopic or surgical findings in the context of a suggestive clinical presentation. This review sets out to investigate diagnostic criteria of AMC.
METHODS: The literature was searched using the databases - PubMed, Medline via OvidSP, ClinicalKey, Informit and the Cochrane Library. Primary studies, published in English, with more than three patients were critically appraised based on study design, methodology and sample size. Exclusion criteria were studies with the following features: post-operative; megarectum-predominant; paediatric; organic megacolon; non-human; and failure to exclude organic causes.
RESULTS: A review of 23 articles found constipation, abdominal pain, distension and gas distress were predominant symptoms. All ages and both sexes were affected, however, symptoms varied with age. Changes in anorectal manometry, histology and colonic transit are consistently reported. Studies involved varying patient numbers, demographics and data acquisition methods.
CONCLUSIONS: Outcome data investigating the diagnosis of AMC must be interpreted in light of the limitations of the low-level evidence studies published to date. Proposed diagnostic criteria include: (1) the exclusion of organic disease; (2) a radiological sigmoid diameter of ~ 10 cm; (3) and constipation, distension, abdominal pain and/or gas distress. A proportion of patients with AMC may be currently misdiagnosed as having functional gastrointestinal disorders. Our conclusions are inevitably tentative, but will hopefully stimulate further research on this enigmatic condition.
METHODS: The literature was searched using the databases - PubMed, Medline via OvidSP, ClinicalKey, Informit and the Cochrane Library. Primary studies, published in English, with more than three patients were critically appraised based on study design, methodology and sample size. Exclusion criteria were studies with the following features: post-operative; megarectum-predominant; paediatric; organic megacolon; non-human; and failure to exclude organic causes.
RESULTS: A review of 23 articles found constipation, abdominal pain, distension and gas distress were predominant symptoms. All ages and both sexes were affected, however, symptoms varied with age. Changes in anorectal manometry, histology and colonic transit are consistently reported. Studies involved varying patient numbers, demographics and data acquisition methods.
CONCLUSIONS: Outcome data investigating the diagnosis of AMC must be interpreted in light of the limitations of the low-level evidence studies published to date. Proposed diagnostic criteria include: (1) the exclusion of organic disease; (2) a radiological sigmoid diameter of ~ 10 cm; (3) and constipation, distension, abdominal pain and/or gas distress. A proportion of patients with AMC may be currently misdiagnosed as having functional gastrointestinal disorders. Our conclusions are inevitably tentative, but will hopefully stimulate further research on this enigmatic condition.
摘要：
背景：获得性巨结肠（AMC）是一种在没有器质性疾病的情况下涉及结肠持续扩张和延长的疾病。诊断取决于主观放射学，在暗示临床表现的情况下的内窥镜或手术发现。本文旨在探讨AMC的诊断标准。
方法：使用数据库搜索文献-PubMed，Medline通过OvidSP，ClinicalKey,信息和Cochrane图书馆。初级研究,以英文出版,根据研究设计对三名以上的患者进行了严格评估，方法和样本量。排除标准是具有以下特征的研究：术后；大直肠占优势；儿科；有机巨结肠；非人类；以及未能排除有机原因。
结果：对23篇文章的回顾发现便秘，腹痛,腹胀和气体窘迫是主要症状。所有年龄和性别都受到影响，然而,症状随年龄而变化。肛门直肠测压的变化，组织学和结肠转运报告一致。研究涉及不同的患者数量，人口统计学和数据采集方法。
结论：研究AMC诊断的结果数据必须根据迄今为止发表的低水平证据研究的局限性来解释。建议的诊断标准包括：（1）排除器质性疾病；（2）放射性乙状结肠直径约10厘米；（3）和便秘，扩张，腹痛和/或气体窘迫。一定比例的AMC患者目前可能被误诊为患有功能性胃肠病。我们的结论不可避免地是初步的，但有望刺激对这种神秘状况的进一步研究。
方法：使用数据库搜索文献-PubMed，Medline通过OvidSP，ClinicalKey,信息和Cochrane图书馆。初级研究,以英文出版,根据研究设计对三名以上的患者进行了严格评估，方法和样本量。排除标准是具有以下特征的研究：术后；大直肠占优势；儿科；有机巨结肠；非人类；以及未能排除有机原因。
结果：对23篇文章的回顾发现便秘，腹痛,腹胀和气体窘迫是主要症状。所有年龄和性别都受到影响，然而,症状随年龄而变化。肛门直肠测压的变化，组织学和结肠转运报告一致。研究涉及不同的患者数量，人口统计学和数据采集方法。
结论：研究AMC诊断的结果数据必须根据迄今为止发表的低水平证据研究的局限性来解释。建议的诊断标准包括：（1）排除器质性疾病；（2）放射性乙状结肠直径约10厘米；（3）和便秘，扩张，腹痛和/或气体窘迫。一定比例的AMC患者目前可能被误诊为患有功能性胃肠病。我们的结论不可避免地是初步的，但有望刺激对这种神秘状况的进一步研究。
