Clinical History
35 year old male presents with an acute exacerbation of ulcerative colitis with severe abdominal pains, profuse diarrhoea and fever.
Imaging Findings
35 year old male presents with an acute exacerbation of ulcerative colitis with severe abdominal pains, profuse diarrhoea and fever.
Discussion
Toxic megacolon is a severe life threatening condition which can complicate inflammatory bowel disease, ischemic colitis, pseudomembranous colitis, infective colitis or Behcets. It affects up to 16% of patients with ulcerative colitis and is less common in Crohn’s colitis. Radiological features include (1) marked colonic dilatation of more than 5cm in diameter, (2) mucosal islands, (3) loss of haustral pattern due to transmural ulceration with destruction of the myenteric plexus, and (4) apparent mural thickening which is due to marked serositis and omental edema. There is actual significant mural thinning due to colonic disintegration. The entire colon may be involved but the transverse colon is usually the most apparent segment on plain radiograph as it is the least dependent portion of the colon and therefore, the easiest to visualize.
Differential Diagnosis List
Toxic megacolon secondary to ulcerative colitis.
Final Diagnosis
Toxic megacolon secondary to ulcerative colitis.
