A 35-year-old male with ulcerative colitis presents with persistent fever, severe abdominal distension, and signs of peritonitis. Abdominal radiograph shows marked non-obstructive colonic dilatation with transverse colon diameter of 8.5 cm. What is the diagnosis?
Answer and explanation
Correct answer: C. Toxic megacolon requiring urgent multidisciplinary intervention
- Step 1: Toxic megacolon is a life-threatening complication of inflammatory bowel disease defined by systemic toxicity and total/segmental colonic dilatation > 6 cm.
- Step 2: Intensive medical therapy (IV corticosteroids, broad-spectrum antibiotics, bowel rest) is initiated; lack of response or perforation mandates emergent subtotal colectomy.
- Step 3: Colonoscopy and barium enema are strictly contraindicated due to high perforation risk.
Answer
Toxic megacolon requiring urgent multidisciplinary intervention.
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