A middle aged male patient presents with fever and diarrhea for 1 week and acute onset pain abdomen for 6 hours. An erect abdominal X-ray was taken as shown. What is the likely diagnosis?
(A) Pseudomembranous colitis (B) Adenocarcinoma colon (C) Pneumatosis intestinalis (D) Toxic megacolon
(D) Answer- D. Toxic megacolonToxic megacolon is a serious life-threatening condition that can occur in patients with ulcerative colitis, Crohn'scolitis, and infectious colitides such as pseudomembranous colitisThis decompensation results in a necrotic thin-walled bowel in which pneumatosisa can often be seen radiographically.Diagnosis:Plain abdominal radiographs are critical for diagnosing toxic megacolon and for following its course.Transverse colon is usually the most dilated >6 cm on supine films.Mutiple air-fluid levels in the colon are common; normal colonic haustlal pattern is either absent or severely disturbed.