Toxic Megacolon

Toxic Megacolon is a life-threatening complication that can occur in various acute or chronic clinical situations. It is characterized by total or segmental non-obstructive colonic dilatation, usually associated with an inflammatory stimulus and toxicity. The most frequent inflammatory cause is inflammatory bowel disease, secondary to Ulcerative Colitis, while the infectious etiology is caused by Clostridium difficile. It is a fact that the cause of inflammation has more to do with the effects of neuromuscular transmission than with neuronal degeneration. Diagnosis is based on clinical and radiological findings. Medical therapy is the first line of treatment in many cases; however, patients who progress with massive hemorrhage, perforation or peritonitis require emergent surgical intervention. Subtotal colectomy with terminal ileostomy is the procedure of choice. Failure to detect this condition early is associated with high morbidity and mortality rates.