[Surgery in severe ulcerative colitis: our experience].
OBJECTIVE
The mortality in severe episodes of ulcerative colitis (UC) has been reduced from 31-61% in the 1950 to 1-3%. Nevertheless it remains high in non specialist centers. Simple criteria are necessary to predict the outcome of severe ulcerative colitis.


METHODS
14 patients hospitalized for severe disease (Truelove and Witts criteria) from 1996 to 2000 were retrospectively analyzed. Patients were divided into two groups: 1. Group A: patients with severe disease surgically treated. 2. Group B: patients with severe disease responders to medical therapy Sex, age, length of steroids medical therapy, fever, stool frequency, CRP, ESR, haemoglobinemia, leukocytes, serum albumin values in the three days before the operation or during the hospitalization were collected.


RESULTS
Total colectomy with ileostomy was necessary in 8 patients (57.1%), while 6 patients (42.90%) were responders to medical therapy. No perioperative mortality was recorded. Stool frequency, CRP, ESR, haemoglobinemia, serum albumin were significantly related to surgical operation.


CONCLUSIONS
1. No uniform criteria off severe attacks, are clearly defined in Literature. 2. The length of pre-operative medical therapy has a tendency to be too high (in our series 19 + 8.2 days). 3. Stool frequency, CRP, ESR, haemoglobinemia, serum albumin were significantly modified in operated patients.
Ghirardi
M
M
Cattedra di Chirurgia Generale, Università degli Studi di Brescia.
Di Fabio
F
F
Mariani
P P
PP
Nascimbeni
R
R
Salerni
B
B
D000328:Adult; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000601:surgery*; D003627:Data Interpretation, Statistical; D004630:Emergencies; D005260:Female; D006801:Humans; D007081:Ileostomy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies