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X-ray appearances of toxic megacolon

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The appearance of a toxic megacolon on plain abdominal radiographs is characterised by:

  • dilatation of the lumen from 6-15 cm
  • the most common sites of dilatation are the right and transverse colons
  • less common sites are the left and sigmoid colons and the rectum
  • there is thickening of the colonic wall with disruption of the normal haustral pattern
  • there may be multiple air-fluid levels

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