Surgery in UC

Q: Ulcerative Colitis (UC) patients who develop acute fulminant colitis may require? (select one)

A) emergent surgery

B) urgent surgery

Answer: B

There are two objectives of this question. First to emphasize the distinction between emergency and urgent surgeries. The second is to distinguish the indications of emergency and urgent indications in UC patients.

Emergency surgery implies immediate take to the operating room (OR). UC patients with life-threatening complication(s) such as colonic perforation, massive gastrointestinal(GI) hemorrhage, and/or toxic megacolon, should be taken to OR immediately. 

Urgent surgery means taking to the OR during the same hospitalization. UC patients with acute fulminant colitis should be first treated with medical therapy. In case of failed medical therapy, urgent surgery should be considered. Acute fulminant colitis is generally defined as more than 10 stools per day along with continuous bleeding, abdominal pain & distension, and acute severe toxic symptoms like fever and anorexia.

#GI

#surgical-critical-care

References:

1. Andersson P, Söderholm JD. Surgery in ulcerative colitis: indication and timing. Dig Dis 2009; 27:335.

2. Ordás I, Eckmann L, Talamini M, et al. Ulcerative colitis (seminar). The Lancet 2012; 380:1606. Available at: http://dx.doi.org/10.1016/S0140-6736(12)60150-0 (Accessed on August 28, 2023).