Fulminant colitis and toxic megacolon.

Twenty-seven cases of fulminant colitis are reported. All had at least five of the seven criteria of severity. Four developed toxic megacolon. Sixty-three per cent failed to respond to parenteral steroids, parenteral nutrition, and vigorous resuscitation and required surgery. Two of the patients with megacolon perforated and died. Prompt attention to these patients and a willingness to rely on surgery are important approaches. The experience reported here reiterates that previously published.