This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Inflammatory Bowel Disease, Subject name: Medicine
A known case of ulcerative colitis presented to emergency with abdominal distension & tenderness. X ray abdomen is given below. Which of the following is true regarding patient condition? 
Select and explain. 
A. Toxic megacolon, B. Rarely seen in ulcerative colitis, C. Sigmoid volvulus, D. Adhesions
A: Toxic megacolon
Answer: A: Toxic megacolon 
Explanation: Given scenario suggests diagnosis of toxic megacolon in a known case of ulcerative colitis patient X ray abdomen shows dilated transverse colon >6 cm It is more commonly seen in ulcerative colitis than crohn disease Can be triggered by electrolyte abnormalities and narcotics Massive dilatation of colon leads to necrotic thin walled colon causing perforation Rx- Medical management- Fluids, IV antibiotics & suppoive Total abdominal colectomy with ileostomy