radiographic appearances of toxic megacolon

Last reviewed 01/2018

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