PMC4446693_01
Preoperative plain film abdominal radiograph of a 26 year old lady with suspected toxic colitis. The single frontal supine view demonstrates a diffusely distended transverse colon with displacement by the gravid uterus.
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Plain film abdominal X-ray demonstrated severe colonic distension without free air (Fig. 1).
Macroscopic aspect of the colonic mucosa after total colectomy. A disruption on the wall of the ascending colon was noted as well as profuse haemorrhage and areas of intramural inflammation, with sparing of the ileocaecal valve and ileum.
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Pathologic examination of the surgical specimen confirmed the diagnosis of toxic megacolon with transmural inflammation and erosion of the bowel wall in regions (Fig. 2).
Infraumbilical laparotomy and closure of ileostomy scars two months after ileostomy reversal.
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The loop ileostomy was reversed three months later (Fig. 3).