An 11-year-old boy with acute fulminant ulcerative colitis (UC) is pre
sented. He had systemic deterioration with frequent diarrhea and letha
rgy. Acute fulminant UC associated with toxic megacolon was diagnosed
by rectal endoscopy and biopsied specimen. He was treated with intensi
ve intravenous administration of prednisolone and total parenteral nut
rition. He recovered completely without any surgical intervention.