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 distention. He is currently being treated for an acute colitis flare characterized by 20 bloody bowel movements daily, fevers to 102°F (38.9°C), and left upper quadrant pain. Physical exam reveals tachycardia and hypotension. Abdominal exam shows distention with signs of focal peritonitis in the left lower quadrant.

Case history #2

A 60-year-old woman presents to the emergency department with a 4-day history of watery diarrhea, 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 exam reveals diffuse abdominal tenderness and distention.

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