Toxic megacolon ultrasound

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]

Overview

Ultrasound may be helpful in the diagnosis of toxic megacolon. Findings on an ultrasound suggestive of toxic megacolon include loss of haustra coli of the colon, hypo-echoic and thickened bowel walls with irregular internal margins in the sigmoid and descending colon and significant dilation of the transverse colon.

Ultrasound

  • Ultrasound may be helpful in the diagnosis of toxic megacolon. Findings on an ultrasound suggestive of toxic megacolon include:[1][2][3][4][5]
    • Loss of haustra coli of the colon,
    • Hypo-echoic and thickened bowel walls with irregular internal margins in the sigmoid and descending colon,
    • Prominent dilation of the transverse colon (>6 cm),
    • Insignificant dilation of ileal bowel loops (diameter >18 mm) with increased intraluminal gas and fluid.

References

  1. Autenrieth DM, Baumgart DC (2012). "Toxic megacolon". Inflamm. Bowel Dis. 18 (3): 584–91. doi:10.1002/ibd.21847. PMID 22009735.
  2. Arienti V, Campieri M, Boriani L, Gionchetti P, Califano C, Giancane S, Furno A, Gasbarrini G (1996). "Management of severe ulcerative colitis with the help of high resolution ultrasonography". Am. J. Gastroenterol. 91 (10): 2163–9. PMID 8855741.
  3. Maconi G, Sampietro GM, Ardizzone S, Cristaldi M, Danelli P, Carsana L, Bianchi Porro G (2004). "Ultrasonographic detection of toxic megacolon in inflammatory bowel diseases". Dig. Dis. Sci. 49 (1): 138–42. PMID 14992448.
  4. Sayedy, Leena (2010). "Toxic megacolon associatedClostridium difficilecolitis". World Journal of Gastrointestinal Endoscopy. 2 (8): 293. doi:10.4253/wjge.v2.i8.293. ISSN 1948-5190.
  5. Moulin V, Dellon P, Laurent O, Aubry S, Lubrano J, Delabrousse E (2011). "Toxic megacolon in patients with severe acute colitis: computed tomographic features". Clin Imaging. 35 (6): 431–6. doi:10.1016/j.clinimag.2011.01.012. PMID 22040786.

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