Toxic megacolon – PFA/CT

Toxic megacolon. This patient with ulcerative colitis presented with severe abdominal pain. The PFA shows toxic megacolon – the transverse colon measures over 8 cm (normal is 6 cm or less), and there is evidence of thickening of the bowel wall (resulting in ‘thumbprinting’). The coronal CT image (performed the same day) also shows colonic dilatation and thickening of the bowel wall; it also shows the pseudopolyps often encountered in toxic megacolon (arrows).