Multiple Rectal Ulcers (43 of 110)

Toxic megacolon is the most severe manifestation of
ulcerative colitis, diagnosed when the inflammation extends
from the superficial mucosa into the submucosal and
muscular layers of the colon. Toxic megacolon occurs more
commonly in the setting of extensive colitis but can also
occur with severe distal colitis. The manifestations of toxic
megacolon include: fever, prostration, severe cramps,
abdominal distention, and abdominal tenderness that may
be localized, diffuse, or associated rebound tenderness.
These toxic manifestations result from transmural
extension of inflammation producing circular muscle
paralysis and precipitating dilation along with a
“tissue-paper” thin colonic wall.