Toxic megacolon

Case contributed by Michael P Hartung


Positive Clostridioides difficile stool test, concern for toxic colitis.

Patient Data

Gender: Male

Diffuse colonic dilation and wall thickening with effacement of haustra.

Fecalization of distal small bowel (small bowel feces sign).

Small volume of ascites.


Postoperative changes right posterior flank. 

Case Discussion

Typical features of toxic megacolon caused by Clostridioides difficile infection, characterized by colonic dilation, wall thickening, and surrounding inflammatory changes. This patient is at great risk for perforation and such cases are often managed with colectomy if there is failure to improve. 

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