CASE 81

History: A 34-year-old man with chronic diarrhea presents acutely unwell with abdominal distention, fever, rectal bleeding, and passage of clots.

1. Which of the following should be included in the differential diagnosis of the imaging finding shown in the figures? (Choose all that apply.)

A. Ischemia

B. Infectious colitis

C. Irritable bowel syndrome

D. Pseudomembranous colitis

E. Inflammatory bowel disease

2. What measurement is used to indicate the seriousness of toxic megacolon?

A. Hypoalbuminemia

B. Hemoglobin

C. Colonic diameter

D. None

3. What is the pathogenesis for the development of toxic megacolon?

A. Severe electrolyte imbalance

B. Failure of cholinergic neurotransmission

C. Transmural inflammation damaging the ganglion cells

D. Dilation due to mechanical failure of downstream passage of colonic contents

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