[Toxic megacolon and its surgical treatment. Results in 21 cases (author's transl)]

The authors present their experience of the toxic colonic dilatation after 21 cases. The frequency of this serious syndrom seems to be in augmentation, and is not any more exclusive of the ulcerative colitis. Actually, pathogeny is not yet known. Diagnosis is established by the standard abdominal X Ray. A continuous clinical, radiological and biological survey is essential, in order to avoid perforation, that is the main complication of the toxic dilatation. The surgical treatment becomes imperative as soon as the failure of the limited medical management is recognized. In this series, total colectomy with or without ileo-rectal anastomosis has been considered as the best surgical operation. Ileo-rectal anastomosis would be possibly protected by a temporary ilestomy.