Diameter of the colon >6cm

Aetiology

• Usually a complication of IBD, most commonly UC
• Can be caused by some infections of the colon e.g. C. diff

Pathophysiology

• Toxins break down the colonic wall, causing damage to the colonic musculature → almost complete paralysis of the affected segment

Clinical features

Symptoms

• Abdominal pain
• Bloating

Signs

• Can induce tachycardia and shock
• Fever

Investigations

• AXR: dilated colon, signs of pneumoperitoneum may be present if dilation has progressed to perforation

Management

• Urgent decompression
• Emergency colectomy if decompression fails