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The consideration for surgery in ulcerative colitis

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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.

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Department of Surgery, University of Nebraska College of Medicine, Omaha, Nebraska.

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Best, R.R. The consideration for surgery in ulcerative colitis. Jour. D. D. 14, 388–392 (1947). https://doi.org/10.1007/BF03001288

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  • Ulcerative Colitis
  • Acriflavine
  • Bowel Continuity
  • Amoebic Dysentery
  • Permanent Ileostomy