A 32-year-old patient with a known history of ulcerative colitis presents to the emergency department with worsening abdominal pain, bloody diarrhea, and fever. On examination, the patient appears acutely ill, and abdominal distension is noted. Laboratory findings reveal leukocytosis, and imaging shows evidence of colonic dilation. Which of the following is the most appropriate indication for emergency surgery in this patient? A. Poor compliance with medications B. Recurrent acute exacerbations C. Growth retardation D. Toxic megacolon Answer: The correct answer is D. Toxic megacolon. Explanation: Toxic megacolon is a life-threatening complication of colitis, characterized by severe colonic distension and systemic toxicity. It requires immediate surgical intervention to prevent further complications and save the patient's life. In this case, the patient's clinical presentation with worsening symptoms, abdominal distension, leukocytosis, and evidence of colonic dilation on imaging strongly suggests toxic megacolon, making it the most appropriate indication for emergency surgery.
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