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Toxic Megacolon

An emergency surgical condition with non-traumatic colon dilation and systemic toxicity that develops on a background of severe colitis.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Toxic Megacolon?

Toxic megacolon is characterized by colonic dilation greater than 6 cm with signs of systemic toxicity, most commonly developing as a complication of ulcerative colitis, Crohn's disease, Clostridioides difficile colitis, or ischemic colitis.

Jalan criteria are used in diagnosis: fever >38.6°C, tachycardia >120, leukocytosis >10,500 or anemia, along with dehydration, electrolyte imbalance, hypotension, or altered consciousness.

Treatment delay results in perforation and high mortality. A multidisciplinary (surgery + gastroenterology) approach is essential.

Symptoms

High fever and tachycardia
Severe abdominal pain and distension
Bloody diarrhea
Abdominal tenderness
Hypotension and dehydration
Altered consciousness
Decreased or absent bowel sounds

Risk Factors

Ulcerative colitis or Crohn's disease
C. difficile infection
Ischemic colitis
Antidiarrheal medication use
Opioid and anticholinergic drugs
After colonoscopy or barium enema
Hypokalemia and electrolyte disorders

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Sudden deterioration in chronic colitis patient
  • High fever, abdominal distension, and bloody stool
  • Decrease in stool frequency with distension
  • Hypotension, altered consciousness
  • Signs of peritonitis

Treatment Methods

01
IV fluid resuscitation and electrolyte correction
02
Nasogastric decompression
03
Broad-spectrum antibiotics and high-dose IV steroids (in IBD)
04
Appropriate antibiotics for C. difficile (vancomycin, fidaxomicin)
05
Surgery: subtotal colectomy + end ileostomy (in cases unresponsive to treatment)
06
Intensive care monitoring and multidisciplinary evaluation

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Genel Cerrahi Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.