Toxic megacolon is a complication of infectious colitis or inflammatory bowel disease and is potentially lethal.
DX: Diagnosis is made with evidence on plain radiography of colonic dilatation along with clinical signs such as fever, leukocytosis, anemia, tachycardia, dehydration, hypotension, altered mental status or electrolyte abnormality.
TX: Initial management of patients with megacolon should be aggressive due to potential mortality. Patients should be monitored in the ICU with serial abdominal X-rays and labs every 12 hours. Bowel rest and nasogastric tube placement are essential first steps in order to assist with gastrointestinal decompression. Initial treatment is medical, but a surgical consult should also be ordered at admission as urgent or emergent presentation may require subtotal colectomy with end-ileostomy, the surgical procedure of choice.
Antibiotics to cover Gram Negatives and Anaerobes.