Toxic megacolon radiology:
Toxic megacolon is a life-threatening widening of the colon paired with severe systemic illness.
Radiology shows segmental or total colonic distension—typically greater than 6 cm at the transverse colon—along with loss of haustral folds, mucosal islands, and a thin, damaged bowel wall.
🚫 Barium enemas and colonoscopy 🚫 are strictly avoided due to perforation risks.
🩻 Key Radiographic Findings 🩻:
Abdominal X-ray:
🔶️ Marked colonic dilation (>6 cm, especially in the transverse colon).
🔶️ Loss of normal haustral markings (ahustral pattern).
🔶️ Mucosal "thumbprinting" or pseudopolyps from severe wall edema and ulceration.
🔶️ Free air under the diaphragm if bowel perforation occurs.
CT Scan:
🔷️ Confirms total or segmental colonic distension.
🔷️ Shows marked pericolic fat stranding and wall abnormalities.
🔷️ Identifies free fluid (ascites) or early micro-perforations.