Management
The principles of management of toxic megacolon include:
- supportive care in the intensive care unit
- nil by mouth and nasogastic tube insertion
- antimotility agents should be stopped
- intravenous fluids, corticosteroids and antibiotics
- serial abdominal radiographs
- daily full blood counts and electrolytes
- blood transfusion for anaemia
- total parenteral feeding if required
- infectious causes of colitis should be treated:
- CMV
- C. difficile
- E. histolytica
- surgery should be considered for:
- progressive dilatation
- worsening toxicity
- haemorrhage
- perforation
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