From this small series of cases, all of which could be considered moderately severe to severe in type, only twelve per cent were subjected to surgery. Possibly a more radical attitude might be taken and ileostomy performed more frequently. True, one might occasionally save another life with the policy of more frequent and earlier surgery but this policy would also give more patients ileostomies, which in itself carries a mortality rate. Also important is the fact that the greater percentage of them probably would have been able to carry on their activities without this undesirable procedure. At present, we do not have sufficient evidence to conclude that early ileostomy in ulcerative colitis will result in permanent cure of the disease and permit permanent closure of the ileostomy and re-establishment of bowel continuity, thus avoiding permanent ileostomy. It is my impression that the case ileostomized in the early stage without an adequate trial by medical management, with subsequent successful closure of the ileostomy, is the type which would have responded satisfactorily to proper medical management. However, ileostomy at times is definitely life saving and at other times is the only means by which we can make ulcerative colitis compatible with life.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Bargen, J. Arnold: The Medical Management of Ulcerative Colitis. J.A.M.A. 126:1009, 1944.
Best, R. Russell: Cod Liver Oil Per Rectum as an Adjunct in the Treatment of Ulcerative Colitis. Am. J. Dig. Dis. 5:426, 1938.
Brown, John Young: Complete Physiological Rest of the Lower Bowel in Ulcerative Lesions, Operative Technique. Surg., Gynec. & Obst. 16:610, 1913.
Cattell, Richard B.: Closure of Ileostomy in Ulcerative Colitis. Ann. Surg. 115:956, 1942.
Cave, Henry W. and Nickel, William F.: Ileostomy. Ann. Surg. 112:747, 1940.
Cave, Henry W.: Late Results in the Treatment of Ulcerative Colitis. Ann. Surg. 124:716, 1946.
Cave, Henry W. and Thompson, James E.: Mortality Factors in the Surgical Treatment of Ulcerative Colitis. Ann. Surg. 114:46, 1941.
Deaver, John B.: Surgical Anatomy. Vol. 3. P. Blakiston’s Son & Co., Philalelphia.
Garlock, John H.: Surgical Treatment of Intractable Ulcerative Colitis. Ann. Surg. 113:2, 1941.
Lium, R.: Observations on the Etiology of Ulcerative Colitis. Am. J. M. Sc. 197:841, 1939.
Mackie, T. T., Eddy, W. W. and Mills, M. A.: Vitamin Deficiencies in Gastrointestinal Disease. Ann. Int. Med. 14:28, 1940.
Rankin, Fred W.: Surgery for Ulcerative Colitis. Surg., Gynec. & Obst. 68:306, 1939.
Streicher, M. H.: Chronic Ulcerative Colitis, Clinical Summary of Management. J.A.M.A. 118:431, 1942.
Sullivan, A. J.: Psychogenic Factors in Ulcerative Colitis. Am. J. Dig. Dis. 2:651, 1936.
Department of Surgery, University of Nebraska College of Medicine, Omaha, Nebraska.
About this article
Cite this article
Best, R.R. The consideration for surgery in ulcerative colitis. Jour. D. D. 14, 388–392 (1947). https://doi.org/10.1007/BF03001288
- Ulcerative Colitis
- Bowel Continuity
- Amoebic Dysentery
- Permanent Ileostomy