Assessment of severity in colitis: a preliminary study.

Lennard‐Jones, J. E.; Ritchie, Jean K.; Hilder, W; Spicer, C. C.

doi:10.1136/gut.16.8.579

Cited by 188 publications

(117 citation statements)

References 10 publications

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“…El hallazgo de íleo o dilatación del colon (diámetro de colon transverso ≥ 5,5 cm) se asocia a mayores tasas de colectomía 54,55 . Además, en algunos casos permite estimar la extensión de la enfermedad y realizar una evaluación basal para comparar en caso de deterioro clínico 56 .…”

Section: Estudios De Imágenes Y Endoscópicos En Cu Graveunclassified

Diagnóstico y manejo de colitis ulcerosa grave: Una mirada actualizada

Hernández-Rocha¹,

Ibáñez²,

Molina³

et al. 2017

Rev. méd. Chile

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Management of severe ulcerative colitis.An up-to-date L a enfermedad inflamatoria intestinal (EII) incluye 2 entidades: Colitis ulcerosa (CU) y la enfermedad de Crohn (EC). Ambas tienen un curso crónico con periodos de remisión y reactivación de variable intensidad. Los episodios de reactivación o crisis se caracterizan por la reaparición o aumento de la diarrea, sangre en deposiciones, dolor abdominal, con o sin sín-tomas sistémicos. En el caso de los pacientes con CU, donde la afectación es exclusivamente del colon y recto, hasta 25% tendrá una crisis grave que requiere hospitalización, pudiendo darse esta situación al debut o en cualquier momento de la evolución 1 . De los pacientes con crisis grave, 20 a 30% no responderá al uso de corticoides intravenosos y de ellos, 80% requerirá colectomía 2 . La mortalidad a corto plazo de la crisis grave es ~ 1% 3 . Por lo tanto, estos pacientes deben ser tratados oportuna y agresivamente, con el fin de evitar complicaciones y reducir la necesidad de colectomía.La incidencia de CU y EC ha aumentado en los últimos años e importantes avances en el diagnós-tico y manejo de estos pacientes han reducido la morbilidad y mortalidad 4 .Lo señalado anteriormente determina que médicos de diversas áreas se vean enfrentados cada vez más frecuentemente a pacientes con CU grave. Por esto, el objetivo de este artículo es revisar y difundir el manejo actual de la crisis grave de CU.

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Section: Estudios De Imágenes Y Endoscópicos En Cu Graveunclassified

Diagnóstico y manejo de colitis ulcerosa grave: Una mirada actualizada

Hernández-Rocha¹,

Ibáñez²,

Molina³

et al. 2017

Rev. méd. Chile

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“…Lennard-Jones et al in 1975 demonstrated the association of bowel frequency, pulse rate, temperature, serum albumin, the presence of mucosal islands and toxic megacolon on abdominal X-ray with failure of medical therapy, as shown in Table 1. 23 A low serum albumin is a useful indicator of mucosal damage, and if low on admission or falls during the ®rst 4 days of attack is associated with increased risk of colectomy. 24,25 A study by Chew et al showed that if there were three or more small bowel loops on abdominal X-ray 73% patients failed to respond to treatment compared to 43% with no ileal loops on X-ray.…”

Section: Factors Predicting Outcomementioning

confidence: 99%

The management of severe ulcerative colitis

Hyde

Jewell²

1997

Aliment Pharmacol Ther

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Severe ulcerative colitis is a potentially life‐threatening condition but the mortality has fallen dramatically over the past 30–40 years. It is now less than 2%, including surgical mortality, and should only be seen in patients with significant co‐existing disease. Early recognition of the severity of the colitis, intensive medical therapy, close liaison between physician and surgeon, and prompt surgery when necessary have all contributed to this improved outcome. Despite the use of high‐dose intravenous corticosteroids, 20–30% of patients will make a poor response and will require urgent surgery. The use of intravenous cyclosporin has proved effective at reducing the immediate surgical rate in this group of unresponsive patients and appears safe. Whether cyclosporin reduces the need for surgery in the longer term is much less certain. Clinical, radiological, endoscopic and laboratory parameters can now be used to predict the course of a severe attack. These help in the timing of urgent surgery and are potentially helpful in determining when to begin other therapies such as cyclosporin.

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“…Additionally, various defi nitions were used to describe the main outcomes. For example, clinical remission has been defi ned as absence of active disease symptoms using Truelove and Witts criteria (the absence of blood and mucus in the stool and the absence of diarrhea), or the Lennard-Jones criteria (two or less bowel movements a day without other signs or symptoms) (Truelove and Witts 1955;Lennard-Jones et al 1975;Rutgeerts et al 2005).…”

Section: Role Of Tnf-α In Ulcerative Colitismentioning

confidence: 99%

Infliximab in ulcerative colitis

Levin

Shibolet²

2008

BTT

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Infl iximab, a monoclonal anti-TNF-α antibody, is commonly used for treatment of moderate to severe Crohn's disease (CD). Its role in the treatment for ulcerative colitis (UC) remains controversial. We review the role of TNF-α in the pathogenesis of UC and describe the randomized, double-blind, placebo-controlled trials and systematic reviews that assess the effi cacy of infl iximab in the treatment of moderate to severe UC.

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Assessment of severity in colitis: a preliminary study.

Cited by 188 publications

References 10 publications

Diagnóstico y manejo de colitis ulcerosa grave: Una mirada actualizada

Diagnóstico y manejo de colitis ulcerosa grave: Una mirada actualizada

The management of severe ulcerative colitis

Infliximab in ulcerative colitis

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