The Treatment of Acute Toxic Ulcerative Colitis by Ileostomy and Simultaneous Colectomy

Fulminating Ulcerative Colitis

“…* Brief details of these patients are set out *The proportion (6%) of patients selected accords well with the 10% of Brooke's (1956) surgical series and the proportion in other series, such as that of Crile and Thomas (1951).…”

Emergency surgery in ulcerative colitis.

“…Crile and Thomas (1951) remark that the causes of death after medical management or ileostomy alone are similar, and that peritonitis is the commonest. Their own results are a graphic illustration of the dangers inherent in a simple ileostomy as the initial procedure.…”

“…Thus Crile and Thomas (1951) (1960), 32 acute colitics were discovered in 520 cases, and 26 were operated on. But comparison with Ripstein (1953), who had an emergency surgery rate of 33 % in 120 surgical cases, or with Goligher (1961), who had 40% emergencies in 104 surgical patients, gives figures comparable with the 27 % of the present series.…”

Primary ileo-anal pouch anastomosis in patients with acute ulcerative colitis

“…The first step, which is HC with end ileostomy, is indicated in severely ill patients due to massive lower digestive tract bleeding, diffuse fecal peritonitis from colonic perforation, fragile tissues due to inflammation and severe inflammatory infiltration within the rectum and mesorectum and for clinical deterioration with progressive dilation in the course of toxic megacolon. The aim of that procedure is to remove the diseased bowel while decreasing the morbidity associated with rectum mobilization and bowel anastomosis [10, 13–15]. However, there has been a shift regarding indications for surgery within the past decades from a decreasing number of patients with toxic megacolon and perforation to an increasing rate of patients with acute colitis unresponsive to intense medical treatment [16, 17].…”