Epidemiology

Etiology

• Bacterial: C. difficile (pseudomembranous colitis), Salmonella, Shigella, Campylobacter infections
• Inflammatory colitis: Ulcerative colitis, Crohn disease

Pathophysiology

• Colonic accumulation of inflammatory mediators and bacteria → nitric oxide synthesis → colonic dilation
• Edema and inflammation of the colonic smooth muscle → colonic dysmotility → colonic dilation

Clinical features

• (Bloody) diarrhea and vomiting
• Abdominal distention and pain
• Signs of sepsis (fever, tachycardia, hypotension) and dehydration

Diagnostics

• Abdominal x-ray findings
  • Dilation of the colon (transverse colon diameter > 6 cm)
  • Loss of haustration
  • Multiple air-fluid levels

Treatment

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