Toxic dilatation of the colon is a complication of acute severe ulcerative colitis, often at initial presentation or early in the disease course. It can also occur in Crohn’s disease and infective colitis, particularly Clostridium difficile colitis. It is important to recognize and initiate prompt treatment to avoid perforation and peritonitis. The condition has a high mortality, particularly with fulminant C. difficile. In ulcerative colitis, more than half of those with toxic dilatation respond to medical treatment and avoid colectomy.
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