Toxic Megacolo

Question 1

Causes

Answer 1

اسباب bloody diarrhea
1-IBD
2-Infections,,,seecy
3-ischemic colitis
4-Cl.difficele infection
5-Hurshsprung
6-pseudomembranous colitis

Question 2

Diagnosis

Answer 2

Diagnostic Criteria (e.g., Jalan’s criteria):
1. Radiographic evidence of colonic dilatation (>6 cm in the transverse colon)
2. Plus at least three of:
*Fever >38.6°C
*Heart rate >120 bpm
*Neutrophilic leukocytosis >10,500/mm³
*Anemia
3. Plus at least one of:4d
Dehydration
Disturbed
Disturbance of electrolytes
Decresed blood pressure

Question 3

Management

Answer 3

NPO (nil per os), IV fluids, electrolyte correction
Broad-spectrum IV antibiotics (e.g., ceftriaxone + metronidazole)
Treatment of underlying cause
IBD-related: IV corticosteroids (e.g., methylprednisolone)

C. difficile-related: Oral vancomycin or fidaxomicin, plus IV metronidazole in severe cases

Surgical Indications:

Perforation

Uncontrolled bleeding

Worsening or no improvement within 24–72 hours

Clinical deterioration

Surgical option: Subtotal colectomy with end ileostomy (most common)