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Emergency surgery for ulcerative colitis

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Abstract

In this article, the role of emergency surgery for severe acute phases of ulcerative colitis is examined. Consideration is given to the diagnosis of the urgent condition, the assessment of the severity of the attack, and the timing of the decision to abandon intensive medical treatment for operation. The form that this emergency intervention should take is then discussed, the author's preference being an ileostomy and subtotal colectomy, and described, in detail, is the operative technique employed in these acute cases. The results obtained from this and other emergency procedures at St. Mark's Hospital, London, and elsewhere are analyzed.

Résumé

Dans cet article est étudié le rÔle de la chirurgie d'urgence pour traiter les accidents aigus de la colite ulcéreuse grave. En premier lieu sont pris en considération le diagnostic de l'attaque aiguË, l'appréciation de sa gravité et le moment où il est temps d'abandonner le traitement médical intensif. Le type de l'intervention d'urgence à pratiquer est discuté, l'auteur marquant une nette préférence pour la colectomie subtotale avec iléostomie dont la description détaillée de la technique employée est donnée. Les résultats obtenus par cette méthode et les autres opérations d'urgence au Saint Mark's Hospital de Londres et ailleurs sont ensuite analysés.

Resumen

Este artículo analiza el papel de la cirugía de emergencia en las fases agudas de la colitis ulcerosa. En el manejo de estos pacientes, primero que todo hay que prestar atención al diagnóstico de la condición clínica de urgencia, a la valoración de la gravedad del ataque y al momento en que se debe decidir el abandono del tratamiento médico intenso en favor de la operación. Luego se discute la modalidad de intervención quirÚrgica que debe ser realizada; el autor indica su clara preferencia por la colectomía subtotal con ileostomía y describe en detalle la técnica operatoria que él emplea en estos casos agudos. También se analizan los resultados obtenidos con éste y otros tipos de procedimiento de emergencia en el St. Mark's Hospital de Londres y en otras instituciones.

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Hawley, P.R. Emergency surgery for ulcerative colitis. World J. Surg. 12, 169–173 (1988). https://doi.org/10.1007/BF01658049

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  • DOI: https://doi.org/10.1007/BF01658049

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