Toxic megacolon is characterized by total or segmental non-obstructive colonic dilatation associated with colitis and systemic toxicity. It is a potentially lethal complication of idiopathic inflammatory bowel disease (ulcerative colitis, Crohn's disease) or infectious colitis.


Toxic megacolon is present if there are:


(1) Radiographic evidence of colon distension at least 6 cm


(2) at least 3 of the following:

(2a) fever > 38° C

(2b) heart rate > 120 per minute

(2c) neutrophilic leukocytosis > 10,500 per µL (10.5 * 10^9 per L)

(2d) anemia


(3) at least one of the following:

(3a) dehydration

(3b) altered consciousness

(3c) electrolyte disturbances

(3d) hypotension


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