Ulcerative colitis with toxic megacolon

Case contributed by David Puyó


Presented to the emergency department with abdominal pain, leukocytosis, hypotension associated with vomiting and diarrhea.

Patient Data

Age: 45 years
Gender: Male

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.

Case Discussion

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.

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