Toxic megacolon of ulcerative colitis in infancy

A 12-week-old white male infant with ulcerative colitis and toxic megacolon is described. His diarrhea and rectal bleeding responded to prednisone. He subsequently developed toxic dilatation of the transverse colon while on salicylazosulfapyridine and one week after discontinuation of prednisone. His toxic megacolon disappeared during close medical observation, readministration of prednisone, and avoidance of repeated abdominal examinations. One year later sigmoidoscopy showed only friable mucosa and the barium enema showed the presence of ulcerative colitis but with improvement from the initial study. Currently he is taking 375 mg of salicylazosulfapyridine daily. Growth and development are normal and he is asymptomatic.