Editing Toxic megacolon (section)

==Pathophysiology==
[[File:Toxisches Megacolon bei Colitis ulcerosa.jpg|thumb|Toxic megacolon in a patient with ulcerative colitis: The patient subsequently underwent a colectomy.|alt=|left]]
[[File:Toxic megacolon 1.JPG|thumb|A pathological specimen showing toxic megacolon]]
The [[Pathology|pathological]] process involves [[inflammation]] and damage to the colonic wall with unknown toxins breaking down the protective mucosal barrier and exposing the [[Muscular layer|muscularis propria]].<ref name="auto">{{cite journal|author1=Michael B|display-authors=et al.|title=Toxic megacolon complicating Crohn's Colitis|pmid=7352781|pmc=1344622|journal=Ann. Surg.|year=1980|volume=191|issue=1|pages=75–80|doi=10.1097/00000658-198001000-00015}}</ref> There is relative destruction of the ganglion cells and swelling of the nerve fibers in the myenteric plexus, with concomitant damage to the colonic musculature.<ref name="auto"/> This results in almost complete [[paralysis]] of the diseased segment of the colon with loss of smooth muscle substance, tone and motility.<ref name="auto"/> 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.<ref name="auto"/>