This results  in almost complete paralysis of the diseased segment of the colon with loss of smooth muscle substance, tone and motility. This can lead to further complications as pressure builds up in the colon due to relative fecal stasis including sepsis, intestinal hemorrhage or free perforation and spontaneous decompression. Diagnosis
"Abdominal X-ray with the features of Air-fluid level can be shown or CT Scan with Contrast can be done if the patient is stable." Treatment
The objective of treatment is to decompress the bowel and to prevent swallowed air from further distending the bowel. If decompression is not achieved or the patient does not improve within 24 hours, a colectomy (surgical removal of all or part of the colon) is indicated. When surgery is required the recommended procedure is a subtotal colectomy with end ileostomy. Fluid and electrolyte replacement help to prevent dehydration and shock. Use of corticosteroids may be indicated to suppress the inflammatory reaction in the colon if megacolon has resulted from active inflammatory bowel disease. Antibiotics may be given to prevent sepsis. Prognosis
If the condition does not improve, the risk of death is significant. In case of poor response to conservative therapy, a colectomy is usually required. References
This article incorporates text from the United States National Library of Medicine (Toxic megacolon), which is in the public domain. Further reading
Ausch, C; Madoff, RD; Gnant, M; Rosen, HR; Garcia-Aguilar, J; Hölbling, N; Herbst, F; Buxhofer, V; Holzer, B; Rothenberger, DA; Schiessel, R (March 2006). "Aetiology and surgical management of toxic megacolon". Colorectal Disease.
Epidemiology
The formation of gummata is rare in developed countries, but common in areas that lack adequate medical treatment.Syphilitic gummas are found in most but not all cases of tertiary syphilis, and can occur either singly or in groups. Gummatous lesions are usually associated with long-term syphilitic infection; however, such lesions can also be a symptom of benign late syphilis. References


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