Toxic colitis and toxic megacolon

Overview 
Theory 
Diagnosis 
Management 
Follow up 
Resources 

Case history #1

A 30-year-old man with a history of ulcerative colitis presents with severe abdominal pain and distension. He is currently being treated for an acute colitis flare characterised by 20 bloody bowel movements daily, fevers to 38.9°C (102°F), and left upper quadrant pain. Physical examination reveals tachycardia and hypotension. Abdominal examination shows distension with signs of focal peritonitis in the left lower quadrant.

Case history #2

A 60-year-old woman presents to the accident and emergency department with a 4-day history of watery diarrhoea, fevers, and worsening abdominal pain. Her significant past medical history includes sinusitis, for which she has been taking antibiotics for the past 3 weeks. She is tachycardic and febrile, and her abdominal examination reveals diffuse abdominal tenderness and distension.

Use of this content is subject to our disclaimer