The clinical and radiological features of diabetic megacolon and gastroparesis occurring in a 48-year-old woman are presented. The only two other well-documented cases of diabetic megacolon from the literature are reviewed. The predominant dilatation of the sigmoidal colon in the setting of a generalized megacolon may be, especially if associated with bladder atony, a clue to the diagnosis of the diabetic nature of a megacolon.
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