A rare and severe case of toxic megacolon: Radiological emergency

Toxic megacolon is a rare and life-threatening complication of ulcerative colitis, representing a medical and surgical emergency with a poor prognosis. We report the case of a 31-year-old man with no significant past medical history, admitted for a 15-day history of bloody mucoid diarrhea associated with general health deterioration. Endoscopic and histopathological findings were consistent with a severe inaugural flare of ulcerative colitis. Despite optimal medical management, the clinical course was marked by the abrupt onset of septic shock. Abdominal imaging revealed acute colonic dilatation consistent with toxic megacolon, leading to an indication for emergency subtotal colectomy. The outcome was unfavorable , with the patient’s death occurring in the context of multiorgan failure.

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Publication Details

Journal
Radiology Case Reports
Published
2026-05-16
DOI
https://doi.org/10.1016/j.radcr.2026.03.003
Primary Topic
Inflammatory Bowel Disease
Type
article
Field-Weighted Citation Impact
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article

A rare and severe case of toxic megacolon: Radiological emergency

Hamid Ziani, Adnane Boubacar, Salma Abddaimi, Imane Kamaoui et al.
Radiology Case Reports
Inflammatory Bowel Disease
article

A rare and severe case of toxic megacolon: Radiological emergency

Hamid Ziani, Adnane Boubacar, Salma Abddaimi, Imane Kamaoui, Imane Skiker, Siham Nasri, Hicham Benramdane
article en

Abstract

Toxic megacolon is a rare and life-threatening complication of ulcerative colitis, representing a medical and surgical emergency with a poor prognosis. We report the case of a 31-year-old man with no significant past medical history, admitted for a 15-day history of bloody mucoid diarrhea associated with general health deterioration. Endoscopic and histopathological findings were consistent with a severe inaugural flare of ulcerative colitis. Despite optimal medical management, the clinical course was marked by the abrupt onset of septic shock. Abdominal imaging revealed acute colonic dilatation consistent with toxic megacolon, leading to an indication for emergency subtotal colectomy. The outcome was unfavorable , with the patient’s death occurring in the context of multiorgan failure.

Radiology Case ReportsVol. 21(8)
Mohamed I University (MA)
No poverty
Openalex Percentile: Top 4%
Inflammatory Bowel Disease
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