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Management of Fulminant Colitis

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Abstract

The treatment of fulminant ulcerative colitis initially depends on the response to corticosteroids, but calculating the pediatric ulcerative colitis activity index (PUCAI) of days 3 and 5 may identify patients who should receive second-line therapy. A PUCAI greater than 45 on day 3 identifies children who are likely to fail corticosteroid therapy, whereas children with a PUCAI greater than 70 on day 5 should receive another medication or surgery. In 70 % of patients with toxic megacolon, a precipitating event such as anticholinergics, opiates, barium enema, or colonoscopy was identified. A multidisciplinary approach that includes stress management and support for the patient and family is essential in order to provide optimal care for children with fulminant colitis.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, Harvard Medical School, Mass General Hospital for Children, CRPZ 5-560, 175 Cambridge Street, 02114, Boston, MA, USA

    Harland Winter MD

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  1. Harland Winter MD
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Correspondence to Harland Winter MD .

Editor information

Editors and Affiliations

  1. Perelman School of Medicine, The Children’s Hospital of Philadelphia, University of Pennsylvania, 34th St. & Civic Ctr. Blvd., Philadelphia, 19104, Pennsylvania, USA

    Petar Mamula

  2. School of Medicine--Greenville, Pediatric Gastroenterology & Nutrition, University of South Carolina, 200 Patewood Drive, Suite A-140, Greenville, 29615, South Carolina, USA

    Jonathan E. Markowitz

  3. Perelman School of Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, 34th St. & Civic Ctr. Blvd., Philadelphia, 19104, Pennsylvania, USA

    Robert N. Baldassano

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Winter, H. (2013). Management of Fulminant Colitis. In: Mamula, P., Markowitz, J., Baldassano, R. (eds) Pediatric Inflammatory Bowel Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5061-0_36

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  • DOI: https://doi.org/10.1007/978-1-4614-5061-0_36

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-5060-3

  • Online ISBN: 978-1-4614-5061-0

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