How should toxic megacolon in the setting of ulcerative colitis be managed?
Aggressive fluid resuscitation, bowel rest, broad-spectrum antibiotics, and intravenous corticosteroids are the mainstays of medical therapy. Serial abdominal examinations and plain films are mandatory to assess for colonic distention or impending perforation. Total abdominal colectomy with end-ileostomy is often required if there is no improvement in 48 hours.
