Toxic megacolon

Background

• Inflammation of intestinal smooth muscle causes colon dilation
• Untreated, can lead to perforation
• Usually associated with infectious colitis or Crohn's disease or Ulcerative Colitis
• Triggers:
  • Anti-motility agents
  • Anticholinergics
  • Narcotics

Clinical Features

• Abdominal Pain
• Fever
• Tachycardia
• Diarrhea
• Distended abdomen
• Hypokalemia
• Hypomagnesemia
• Perforation
  • Peritonitis
  • Septicemia

Differential Diagnosis

• Small bowel obstruction
• Large Bowel Obstruction
• Constipation
• C. difficile colitis

Diagnosis

• X-ray showing colon > 6 cm diameter
  • Can also see loss of haustra, "thumb-printing" (bowel edema)