Toxic megacolon: results of emergency colectomy

In order to assess the results of emergency colectomy for toxic megacolon in ulcerative colitis, the records of 40 patients treated over a 16-year period were reviewed. The diagnosis of toxic;colon was confirmed by a combination of clinical, radiologic, operative and pathologic examinations. Steroids were part of the treatment before operation in 36 patients. The surgical procedures included subtotal celectomy in 37 patients and total proctocolectomy in 3. Fecal spillage was recognized in 10 procedures. Two patients died postoperatively, but in neither had fecal contamination been observed. The findings of this review support the use of colectomy as the surgical treatment for toxic megacolon.