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Review
. 2023 Dec 29;37(6):404-410.
doi: 10.1055/s-0043-1777665. eCollection 2024 Nov.

Management of Severe Colitis and Toxic Megacolon

Marjorie R Liggett  1 , Hasan B Alam  1
Affiliations
Review

Management of Severe Colitis and Toxic Megacolon

Marjorie R Liggett et al. Clin Colon Rectal Surg. .

Abstract

Severe colitis is a well-defined condition encompassing several etiologies but is most often caused by severe ulcerative colitis or Clostridioides difficile infection. Severe colitis can evolve into toxic colitis, or toxic megacolon when associated with bowel dilation and systemic manifestations, resulting in a life-threatening scenario where multidisciplinary management is often required. Medical management continues to play an important role in the initial treatment of toxic megacolon. However, timely surgical intervention can be lifesaving.

Keywords: subtotal abdominal colectomy with end ileostomy; toxic colitis; toxic megacolon.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Plain film of toxic megacolon demonstrating dilated transverse colon.
Fig. 2
Fig. 2
Management algorithm of acute severe ulcerative colitis (UC). Abbreviations: CRP, C-reactive protein; CT, computed tomography; ESR, erythrocyte sedimentation rate; IV, intravenous; NSAIDs, nonsteroidal anti-inflammatory drugs.
Fig. 3
Fig. 3
Management algorithm of fulminant Clostridioides difficile colitis. Abbreviations: IV, intravenous; WBC, white blood cell.
See this image and copyright information in PMC

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