Toxic Megacolon (Toxic Colitis)
Description
A rapid enlargement of the large intestine (colon) caused by inflammation of the colon (colitis). All of the colon or only a portion can be involved. The cause of the colitis can be inflammatory bowel disease such as ulcerative colitis, infection, decreased blood supply (ischemia), or radiation. The disease can be very serious with 4-5% of affected patients dying. Patients are generally sick as well with fever and rapid heart rate.
Symptoms
Abdominal pain, abdominal swelling, fever, rapid heart rate, low blood pressure, diarrhea, rectal bleeding, painful defecation, vomiting.
Tests
A history and physical exam will be done. Lab tests and imaging tests will be performed to identify the condition and determine the cause of the toxic megacolon.
- CBC
- Chem 12
- CT Scan
- lactate
- Lipase
- X-Ray
Treatment
Therapy is aimed at stopping the enlargement of the colon, stabilizing the patient's vital signs and treating the underlying cause of the condition. Patients will receive intravenous fluids, antibiotics, and steroids. Surgery may be needed if the colon continues to expand, if a hole develops in the colon (perforation) or if the patient experiences significant bleeding.
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