Ulcerative colitis with toxic megacolon
Presented to the emergency department with abdominal pain, leukocytosis, hypotension associated with vomiting and diarrhea.
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Diffuse thickening of the entire colon, mainly involving sigmoid and descending colon. Colonic dilatation with transverse colon diameter reaching 8.4 cm. No small bowel dilatation or pneumoperitoneum.
Toxic megacolon is acute dilatation of the non-obstructed colon, total or segmental,
accompanied by signs of systemic toxicity, which occurs as a consequence of severe inflammation of the colon.
Classically, toxic megacolon was considered to be exclusively related to severe ulcerative colitis but it is now known that it may also complicate severe forms of Crohn's disease or pseudomembranous colitis.