Fact-sheet: Toxic megacolon
Updated on 06/29/2020 at 11:09 AM
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Definition
Rare and severe complication of ulcerative colitis, but also of ischemic and infectious colitis, particularly due to Clostridium difficile or cytomegalovirus
Clinical features
Sepsis with marked colonic dilation, without obstruction
CT
Extensive colonic dilation, with a diameter greater than 6 cm, containing fluid or gas
Loss of colonic haustration
Pericolic fat infiltration and intraperitoneal effusion
Management
Medical treatment as a first step (corticosteroids, cyclosporine, endoscopic decompression, and hyperbaric oxygen therapy), provided this does not delay surgical treatment (colectomy) in the absence of a rapid response.