Multiple Rectal Ulcers (38 of 110)

Computed Tomography Scout View in the second day of the second hospitalization

Toxic megacolon is a potentially lethal complication of
inflammatory bowel disease (IBD) or infectious colitis that
is characterized by total or segmental nonobstructive
colonic dilatation plus systemic toxicity.

Toxic megacolon is characterized by an acute dilation of all
or part of the colon to a diameter greater than 6 cm.
(measured in the mid-transverse colon) and is associated
with severe systemic toxicity. Toxic megacolon occurs in
1– 2% of patients with ulcerative colitis. Histological
examination reveals extensive deep ulcerations and acute
inflammation that involves all muscle layers of the colon
and often extends to the serosa. This widespread
inflammation accounts for toxic megacolon’s systemic
toxicity (fever, tachycardia, localized abdominal pain and
leukocytosis) The loss of colonic muscular tone results in
the dilation of the colon.