Sixteen patients with toxic dilatation of the colon were reviewed. Medical treatment reversed the acute process in four patients; however, all four later came to colectomy with ileostomy because of persistent or recurrent symptoms of ulcerative colitis. Twelve patients failed to improve on medical therapy and underwent emergency colectomy with ileostomy. Operative mortality was 25% and was related directly to the interval between onset of toxic dilatation and operation.
Of seven patients operated on less than five days after onset of toxic dilatation, none died, whereas three died of the five operated on later than five days.
Adams JT. Toxic Dilatation of the ColonA Surgical Disease. Arch Surg. 1973;106(5):678-682. doi:10.1001/archsurg.1973.01350170046011