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
AND
(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
AND
(3) at least one of the following:
(3a) dehydration
(3b) altered consciousness
(3c) electrolyte disturbances
(3d) hypotension
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