case_images: PMC11371572_01
case_images: (A) Anteroposterior chest radiograph demonstrating significant colonic dilation. The radiograph reveals extensive gaseous distension of the colon, characteristic of toxic megacolon. The diaphragm is elevated, and there is notable colonic distension. (B) The image highlights the extent of colonic dilation with air-fluid levels indicative of an obstructive process. The patient exhibits marked gaseous distension of the intestines, consistent with the diagnosis of toxic megacolon.
case_images: fsurg-11-1434523-g001.jpg
case_images: PMC11371572_01_fsurg-11-1434523-g001.jpg
case_images: F1
case_images: Abdominal anteroposterior supine radiography revealed dilated intestinal loops and air fluid levels, suggesting acute obstruction (Figure 1).
case_images: (A) Coronal CT scan displaying significant colonic dilation with extensive gaseous distension. (B) Sagittal CT scan showing severe abdominal distension and colonic dilation.
case_images: fsurg-11-1434523-g002.jpg
case_images: PMC11371572_01_fsurg-11-1434523-g002.jpg
case_images: F2
case_images: Abdominal computed tomography (CT) showed intestinal occlusion due to fecal impaction in the rectum and cecal dilatation of 11.6 cm (Figure 2).
case_images: (A) Intraoperative view showing the initial incision and exposure of the markedly distended colon. The image demonstrates the surgical approach taken to access the affected bowel. (B) Intraoperative image depicting the resected colon during total colectomy. The surgical team is shown handling the excised specimen, which displays severe distension and pathological changes characteristic of toxic megacolon.
case_images: fsurg-11-1434523-g003.jpg
case_images: PMC11371572_01_fsurg-11-1434523-g003.jpg
case_images: F3
case_images: In addition, the patient presented perforations in the anterior (1.5 cm x 1.5 cm) and lateral (1.0 cm x 1.0 cm) portions of sigmoid colon (Figure 3).
case_images: The resected specimen colon is markedly dilated, with extensive areas of congestion, hemorrhage, and ulceration visible on the mucosal surface. The segment exhibits both pan-colonic dilation and structural compromise.
case_images: fsurg-11-1434523-g004.jpg
case_images: PMC11371572_01_fsurg-11-1434523-g004.jpg
case_images: F4
case_images: In the sigmoid colon, extensive irregular ulcers were observed on the mucosal surface, measuring up to 20 cm in length and 10 cm in width and deep with raised edges (Figure 4).