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Barium enema and colonoscopy are contraindicated in severeattacks of ulcerative colitis because of the possibility of toxic megacolon andperforation. The authors have assessed abdominal ultrasound in 38 patients withsevere ulcerative colitis. Ultrasound revealed bowel wall thicknesses rangingfrom 3.9 to 9.2 mm (mean 7.7) extending the whole length of the colon, to thetransverse colon, and to the descending colon, respectively, in 18, 10 and eightpatients. The degree of bowel thickening was related to the severity of inflammationbased on clinical, sigmoidoscopic and histological evaluation. In twopatients, ultrasound showed a thin bowel wall distended without motility,suggesting the diagnosis of toxic megacolon (confirmed radiologically). Anexcellent correlation (95%) was found between ultrasound and technetium-99scanning. Ultrasound might be a reasonable first investigation in the assessmentof patients with severe ulcerative colitis

Management of Severe Attacks of Ulcerative Colitis with New Technologies