Surgery for Fulminant Colitis
Fulminant colitis can be considered as an acute and progressive inflammatory disorder of the large bowel mucosa which has failed to respond to escalating medical therapy and for which surgical intervention must be considered. Ulcerative colitis (UC) remains the commonest cause of this condition, but changing patterns of disease and increasing levels of intervention mean that other causes must be frequently considered. There are considerable and ongoing advances in medical therapy for this condition which are influencing the decision to proceed to surgery. By comparison, the surgical treatment itself has changed little over the last 30 years. Optimal management requires a multidisciplinary approach with close collaboration between the gastroenterologist, surgeon, nutrition team, and colorectal nurse specialist. The key to successful management of these patients is timely surgery before large bowel perforation and before the patient is too debilitated to withstand the surgical insult. This chapter will cover the recent changes in fulminant colitis and its management.
KeywordsUlcerative Colitis Clostridium Difficile Infection Ischemic Colitis Stool Frequency Subtotal Colectomy
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