Toxic Megacolon

Diameter of the colon >6cm

Aetiology

  • Usually a complication of IBD, most commonly UC
  • Can be caused by some infections of the colon e.g. C. diff

Pathophysiology

  • Toxins break down the colonic wall, causing damage to the colonic musculature → almost complete paralysis of the affected segment

Clinical presentation

  • Abdominal pain
  • Bloating
  • Can induce tachycardia and shock
  • Fever

Investigations

  • AXR

Management

  • Urgent decompression
  • Emergency colectomy if decompression fails