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[Surgical therapy of severe colitis].
Chirurg. 1996 Feb; 67(2):150-4.C

Abstract

Severe colitis, eventually complicated by toxic megacolon, perforation or massive hemorrhage still represents a potentially life threatening complication during the course of inflammatory bowel disease reaching a mortality of almost 40% if not operated in time. From 1.1.1973 until 30.4.1994 22 patients (13 men, 9 women, mean age 29 years) with either ulcerative colitis or Crohn's disease of the colon were operated on for severe colitis. Indications for operative treatment were as follows: 7 patients relapsed conservative medical treatment, 8 developed toxic megacolon and in 7 patients perforation occurred. Diagnosis was based on the clinical criterias first described by Turnbull. In 11 (50%) cases subtotal colectomy with an ileostomy and intrapelvic Hartmann's pouch was performed, in 4 (18%) patients a Turnbull's procedure was carried out with loop ileostomy and colostomies and in 3 (14%) cases a left hemicolectomy and transversostomy was applied. In two patients with Crohn's disease an ileocolic resection was done because of perforation, one received a subtotal colectomy and ileorectal anastomosis and one patient was operated by a right hemicolectomy and ileostomy. One patient with ulcerative colitis died, reaching a post-operative mortality of 4.5%. After an intervall of approximately 18 months in the 16 surviving patients with ulcerative colitis an ileal pouch-anal procedure could be done. Of the 5 patients with Crohn's disease one had to be operated on for recurrence, the other patients have been free of recurrent Crohn's disease for a follow-up time between 3 and 11 years. We conclude, provided early operative treatment is intended, that subtotal colectomy with Hartmann's pouch and ileostomy is the procedure of choice in patients with severe colitis.

Authors+Show Affiliations

Chirurgische Klinik, RWTH Aachen.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

ger

PubMed ID

8881212

Citation

Seelig, M H., et al. "[Surgical Therapy of Severe Colitis]." Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen, vol. 67, no. 2, 1996, pp. 150-4.
Seelig MH, Uhlig H, Braun J, et al. [Surgical therapy of severe colitis]. Chirurg. 1996;67(2):150-4.
Seelig, M. H., Uhlig, H., Braun, J., & Schumpelick, V. (1996). [Surgical therapy of severe colitis]. Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen, 67(2), 150-4.
Seelig MH, et al. [Surgical Therapy of Severe Colitis]. Chirurg. 1996;67(2):150-4. PubMed PMID: 8881212.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Surgical therapy of severe colitis]. AU - Seelig,M H, AU - Uhlig,H, AU - Braun,J, AU - Schumpelick,V, PY - 1996/2/1/pubmed PY - 1996/2/1/medline PY - 1996/2/1/entrez SP - 150 EP - 4 JF - Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen JO - Chirurg VL - 67 IS - 2 N2 - Severe colitis, eventually complicated by toxic megacolon, perforation or massive hemorrhage still represents a potentially life threatening complication during the course of inflammatory bowel disease reaching a mortality of almost 40% if not operated in time. From 1.1.1973 until 30.4.1994 22 patients (13 men, 9 women, mean age 29 years) with either ulcerative colitis or Crohn's disease of the colon were operated on for severe colitis. Indications for operative treatment were as follows: 7 patients relapsed conservative medical treatment, 8 developed toxic megacolon and in 7 patients perforation occurred. Diagnosis was based on the clinical criterias first described by Turnbull. In 11 (50%) cases subtotal colectomy with an ileostomy and intrapelvic Hartmann's pouch was performed, in 4 (18%) patients a Turnbull's procedure was carried out with loop ileostomy and colostomies and in 3 (14%) cases a left hemicolectomy and transversostomy was applied. In two patients with Crohn's disease an ileocolic resection was done because of perforation, one received a subtotal colectomy and ileorectal anastomosis and one patient was operated by a right hemicolectomy and ileostomy. One patient with ulcerative colitis died, reaching a post-operative mortality of 4.5%. After an intervall of approximately 18 months in the 16 surviving patients with ulcerative colitis an ileal pouch-anal procedure could be done. Of the 5 patients with Crohn's disease one had to be operated on for recurrence, the other patients have been free of recurrent Crohn's disease for a follow-up time between 3 and 11 years. We conclude, provided early operative treatment is intended, that subtotal colectomy with Hartmann's pouch and ileostomy is the procedure of choice in patients with severe colitis. SN - 0009-4722 UR - https://www.unboundmedicine.com/medline/citation/8881212/[Surgical_therapy_of_severe_colitis]_ L2 - https://medlineplus.gov/crohnsdisease.html DB - PRIME DP - Unbound Medicine ER -