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Toxic megacolon is a rare but life-threatening condition. Diagnosis is made when both systemic toxicity and an enlarged colon are present. We undertook a systematic review of the literature to provide a list of toxic megacolon findings on computed tomography (CT) imaging along with the prevalence rate for each finding. PubMed, Embase, and Cochrane library were searched. After eligibility screening and quality assessment, the reported CT findings of toxic megacolon with their respective prevalence rates were extracted from the included st