Toxic megacolon


  • Colonic Dilation ≥6cm
  • Therapy: Fluids, Electrolyte Repletion, Steroids, Antibiotics, Surgical Consultation
  • AVOID anticholingerics, anti-motility agents, opioids


Clinical Features

Differential Diagnosis



  • Fluid resuscitation
  • IV corticosteroids
    • Hydrocortisone IV 100mg q6h
  • Triple Antibiotic Therapy
  • Electrolyte repletion
    • Aggressively treat hypokalemia and hypomagnesemia because these can exacerbate dilation
  • Emergent Surgical Consultation
  • Obtain blood cultures, stool cultures, C. Diff Toxin
  • If known cause is C. Diff treat with Vancomycin or Metronidazole
  • If known cause is CMV can add Ganciclovir
  • Avoid
    • Anticholinergics, anti-motility agents, opioids which can worsen dilation
    • Sulfasalazine or 5-aminosalicylate (5-ASA) unhelpful
    • Nasogastric (NG) Tube NOT effective in reducing colonic distention


  • Admit

See Also


    This article is issued from Wikem. The text is licensed under Creative Commons - Attribution - Sharealike. Additional terms may apply for the media files.