Intraperitoneal Perforation of the Colon in Ulcerative Colitis [<i>Abridged</i>]

“…Intraperitoneal perforation of the colon is the most lethal local complication of acute ulcerative colitis. The risk appears to be highest in the initial attack (9.7%) rather than in subsequent attacks (1.8%) [33]. The perforation may be free, or more commonly sealed by adherent viscera or omentum.…”

Section: Colonic Complicationsmentioning

confidence: 98%

Radiology in the current assessment of ulcerative colitis

Bartram

1976

Gastrointest Radiol

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Abstract. Plain abdominal radiography in acute ulcerative colitis is essential to detect acute colonic complications, such as acute dilatation and free perforation. Sealed perforations may not be detected. Useful information can be gained as to the extent and severity of the mucosal lesions, but can be unreliable so that a contrast examination is required. The double contrast barium enema is more accurate than the single contrast study in revealing the early mucosal lesions of colitis. It is the examination of choice to show the extent and severity of disease, and is of considerable value in the differential diagnosis of colitis. In active colitis, the unprepared double contrast barium enema is recommended. The success of the examination relies on the absence of fecal residue adjacent to an active mucosa. The technique, uses, and limitations of this type of examination are described.In the long-term management of colitis, the role of radiology is to show the presence of extensive disease, which indicates an increased risk of malignancy. Lesions such as strictures or polyps may be found and are more likely to be benign than malignant, but confirmation often requires endoscopic biopsy. In the search for malignancy regular barium enema examination is not recommended, as this can only reveal an overt tumor, whereas premalignancy can be detected histologically from an endoscopic biopsy.

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“…Of this number, 11 patients were definitely not in the first attack of their disease; this finding is similar to that of Jalan, Sircus, Card, Falconer, Bruce, Crean, McManus, Small, and Smith (1969a) who found that, of 16 patients who sustained perforation, 11 did so during a relapse and only five in their first attack. Other authors (Edwards and Truelove, 1964;de Dombal, Watts, Watkinson, and Goligher, 1965) have found perforation to be more common during the initial attack of ulcerative colitis. Surgery in the presence of perforation carries a very poor prognosis: 13 of the 20 patients reported here died postoperatively.…”

Section: Discussionmentioning

confidence: 94%

“…1955195619571958195919611962196319641965 Preoperative severity of the disease As preoperative grading was impossible in 77 cases, analysis of this factor in postoperative mortality has been limited to patients undergoing colectomy and ileostomy or total proctocolectomy and is given in The operation of colectomy and ileostomy carried a very low mortality (1-05%) in all hospitals when undertaken electively in patients graded as A or B cases preoperatively. Increasing severity of the disease led to a rising postoperative mortality, considerably more evident in the non-teaching hospitals surveyed.…”

Section: Agementioning

confidence: 99%

Ileostomy and excisional surgery for chronic inflammatory disease of the colon: A survey of one hospital region: Part I Results and complications of surgery

Ritchie¹

1971

Gut

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SUMMARY Four hundred and fifty-three patients who underwent ileostomy and excisional large bowel surgery for chronic inflammatory disease at two teaching hospitals and 35 non-teaching hospitals within the North East Metropolitan Hospital Region during the years 1955-66 were surveyed through a study of hospital case records. The surgical results and complications are presented in part I ; a study of the health of these patients after their discharge from hospital is made in part II in an attempt to answer the question posed by many ileostomists, 'Are we as healthy as other people?' Part I Results and complications of surgeryPublished reports on the results of colectomy and ileostomy for inflammatory bowel disease have previously been confined to patients operated upon by a single surgeon or a small group of surgeons at a single hospital. These reports, while giving information on surgical results in expert hands, may well not be representative of the situation in the country as a whole: this paper is an analysis of a sample of patients treated at a number of hospitals.

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Intraperitoneal Perforation of the Colon in Ulcerative Colitis [Abridged]

Cited by 20 publications

References 18 publications

Pneumomediastinum in Inflammatory Bowel Disease

Pneumomediastinum in Inflammatory Bowel Disease

Radiology in the current assessment of ulcerative colitis

Ileostomy and excisional surgery for chronic inflammatory disease of the colon: A survey of one hospital region: Part I Results and complications of surgery

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