中毒性巨结肠（toxic megacolon，TMC）是各种炎症性肠病、细菌性肠病和病毒性肠病等的一种致命并发症，常见于溃疡性结肠炎病人。该病通常发生于急性重症溃疡性结肠炎或慢性溃疡性结肠炎急性发作阶段。某些具有麻醉作用的药物如鸦片类、抗胆碱酯类和止泻药以及某些不适宜的医疗操作（如结肠镜检查）等可诱发其发作，一旦确立诊断，应立即进行挽救性治疗。为降低手术风险，提高手术成功率，对于病情危急的TMC病人，应遵循三期手术原则进行外科治疗。

Diagnosis and surgical treatment of toxic megacolon        QIU Hui-zhong, ZHOU Jiao-lin. Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
Corresponding author: QIU Hui-zhong, E-mail:qiuhzpumc@yahoo.com.cn
Abstract    Toxic megacolon is a life-threatening complication of bowel diseases including the inflammatory bowel diseases, bacterial enteritis, viral enteritis, etc. It frequently develops in patients afflicted with ulcerative colitis, mostly in the acute severe ulcerative colitis or during the acute attack of the chronic ulcerative colitis. Medications including opioids, anticholinergic agents, antidiarrheal agents, as well as some improperly applied medical interventions such as colonoscopy may induce this condition. Once the diagnosis is confirmed, the rescue therapy should be initiated immediately. In order to reduce surgical complication and to improve the surgical success rate, the policy of using the 3-step operation should be followed in treating critical ill patients with toxic megacolon.