Chronic ulcerative colitis

Summary

The complications of chronic ulcerative colitis are varied, and they occur locally in the colon as well as outside of the digestive tract. Over 100 complications were observed in our series of 220 patients. We have classified these as to whether the particular complication usually is treated medically or surgically. Most of the extracolonic complications such as skin lesions, arthritis, hepatic insufficiency, and gonadal insufficiency are managed medically; and complications arising in the colon such as fistula, polyp, stricture, perforation, carcinoma, and massive hemorrhage are managed surgically. Since a small group of patients with chronic ulcerative colitis do not respond to medical management, we have referred to this as medical intractability. About 5 per cent of our patients were thus classified. When medical intractability occurs, the patient is best treated surgically. It has been our experience that surgical treatment most often becomes necessary because local complications develop in the colon rather than because of failure of medical management or medical intractability in the uncomplicated case of chronic ulcerative colitis.