Toxic dilatation of the colon in the course of ulcerative colitis.

Toxic dilatation of the colon has been observed in a patient suffering from ulcerative colitis during an acute relapse of the disease. This uncommon and serious complication was suspected because there was a gradual worsening of the patient's condition, accompanied by toxic phenomena. The diagnosis was confirmed by a flat plate of the abdomen which disclosed considerable dilatation of the colon. The etiology of toxic dilatation is not known but the use of opiates and anticholinergic agents has been suggested as a possible factor. These therapeutic agents should be avoided in the acute stage. Barium enema examination during acute relapses of ulcerative colitis may also precipitate the onset of this complication. It is recommended that, during the acute stage of the disease, the barium enema be replaced as often as possible by flat films of the abdomen which also enable diagnosis of this complication.