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Toxic Megacolon
Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Acute transmural fulminant colitis with neuromuscular degeneration and colonic dilation

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Jethwa KD et al: The importance of the abdominal X-radiograph in acute ulcerative colitis. Arch Dis Child Educ Pract Ed. 99(5):188, 200, 2014
                                        2. Kazanowski M et al: Clostridium difficile: epidemiology, diagnostic and therapeutic possibilities-a systematic review. Tech Coloproctol. 18(3):223-32, 2014
                                        3. Miniello S et al: Toxic megacolon in ulcerative rectocolitis. Current trends in clinical evaluation, diagnosis and treatment. Ann Ital Chir. 85(1):45-9, 2014
                                        4. Narabayashi K et al: Oral tacrolimus for megacolon in patients with severe ulcerative colitis. Intern Med. 53(16):1755-8, 2014
                                        5. Yu S et al: Fecal Transplant for Treatment of Toxic Megacolon Associated With Clostridium Difficile Colitis in a Patient With Duchenne Muscular Dystrophy. Am J Ther. ePub, 2014
                                        6. Seltman AK: Surgical Management of Clostridium difficile Colitis. Clin Colon Rectal Surg. 25(4):204-9, 2012
                                        7. Ambrosini R et al: Inflammatory chronic disease of the colon: how to image. Eur J Radiol. 61(3):442-8, 2007
                                        8. Saunders MD: Acute colonic pseudo-obstruction. Gastrointest Endosc Clin N Am. 17(2):341-60, vi-vii, 2007
                                        9. Gan SI et al: A new look at toxic megacolon: an update and review of incidence, etiology, pathogenesis, and management. Am J Gastroenterol. 98(11):2363-71, 2003
                                        10. Latella G et al: GI distension in severe ulcerative colitis. Am J Gastroenterol. 97(5):1169-75, 2002
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Definitions

                                                      • Acute transmural fulminant colitis with neuromuscular degeneration and colonic dilation

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Gross Pathologic & Surgical Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Jethwa KD et al: The importance of the abdominal X-radiograph in acute ulcerative colitis. Arch Dis Child Educ Pract Ed. 99(5):188, 200, 2014
                                                                              2. Kazanowski M et al: Clostridium difficile: epidemiology, diagnostic and therapeutic possibilities-a systematic review. Tech Coloproctol. 18(3):223-32, 2014
                                                                              3. Miniello S et al: Toxic megacolon in ulcerative rectocolitis. Current trends in clinical evaluation, diagnosis and treatment. Ann Ital Chir. 85(1):45-9, 2014
                                                                              4. Narabayashi K et al: Oral tacrolimus for megacolon in patients with severe ulcerative colitis. Intern Med. 53(16):1755-8, 2014
                                                                              5. Yu S et al: Fecal Transplant for Treatment of Toxic Megacolon Associated With Clostridium Difficile Colitis in a Patient With Duchenne Muscular Dystrophy. Am J Ther. ePub, 2014
                                                                              6. Seltman AK: Surgical Management of Clostridium difficile Colitis. Clin Colon Rectal Surg. 25(4):204-9, 2012
                                                                              7. Ambrosini R et al: Inflammatory chronic disease of the colon: how to image. Eur J Radiol. 61(3):442-8, 2007
                                                                              8. Saunders MD: Acute colonic pseudo-obstruction. Gastrointest Endosc Clin N Am. 17(2):341-60, vi-vii, 2007
                                                                              9. Gan SI et al: A new look at toxic megacolon: an update and review of incidence, etiology, pathogenesis, and management. Am J Gastroenterol. 98(11):2363-71, 2003
                                                                              10. Latella G et al: GI distension in severe ulcerative colitis. Am J Gastroenterol. 97(5):1169-75, 2002