PriMera Scientific Surgical Research and Practice (ISSN: 2836-0028)

Case Report

Volume 2 Issue 4

Toxic Megacolon: A Conundrum

Mohamed Shafi Mahboob Ali*

September 26, 2023


Toxic megacolon is defined as an acute non-obstructive inflammatory condition with dilatation of the bowel causing septicemia and peritonitis. The cut off point for the bowel dilatation is taken as 6cm and above with loss of haustration on imaging. The exact cause of toxic megacolon is still debatable but several postulations have been laid down. The etiology of toxic megacolon can be divided into several factors such as inflammatory, autoimmune, tumors and others. Toxic megacolon carries a high morbidity and mortality with delayed interventions. The incidence increases with age with male preponderance.


  1. Ciccocioppo R and Corazza GR. “In-hospital mortality for toxic megacolon”. Intern Emerg Med 13.6 (2018): 837-838.
  2. Doshi R., et al. “Incidence, features, in-hospital outcomes and predictors of in-hospital mortality associated with toxic megacolon hospitalizations in the United States”. Intern Emerg Med 13.6 (2018): 881-887.
  3. McDonald LC., et al. “Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA)”. Clin Infect Dis 66.7 (2018): e1-e48.
  4. Bagdasarian N, Rao K and Malani PN. “Diagnosis and treatment of Clostridium difficile in adults: a systematic review”. JAMA 313.4 (2015): 398-408.
  5. Alemayehu G and Jarnerot G. “Colonoscopy during an attack of severe ulcerative colitis is a safe procedure and of great value in clinical decision making”. Am J Gastroenterol 86.2 (1991): 187-190.
  6. Mourelle M., et al. “Induction of nitric oxide synthase in colonic smooth muscle from patients with toxic megacolon”. Gastroenterology 109.5 (1995): 1497-502.
  7. Neal MD., et al. “Diverting loop ileostomy and colonic lavage: an alternative to total abdominal colectomy for the treatment of severe, complicated Clostridium difficile associated disease”. Ann Surg 254.3 (2011): 423-429.