surgery-anesthesia-euro-gastro-congress-2018-posters

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N o v e m b e r 1 2 - 1 3 , 2 0 1 8 | R o m e , I t a l y

Joint Event on

OF EXCELLENCE

IN INTERNATIONAL

MEETINGS

YEARS

Surgery and Anesthesia 2018 & Euro Gastro Congress 2018

Case Reports in Surgery and Invasive Procedures

Volume 2

GASTROENTEROLOGY

International Conference on

SURGERY AND ANESTHESIA

International Conference on

Case Rep Surg Invasive Proced 2018, Volume 2

SURGERY OF ACUTE SEVERE ULCERATIVE COLITIS, SUBTOTAL

COLECTOMY: WHEN AND HOW TO DO IT?

Rosario Fornaro, Andrea Razzore

Marco Casaccia, Emanuela Stratta, Giuseppe Caristo

and

Marco Frascio

University of Genoa Policlinico San Martino Hospital, Italy

o focus on the role of surgery in the management of acute ulcerative colitis (UC). UC is a chronic inflammatory disease of the

mucosa of the large intestine.

Results:

Acute severe colitis (ASC) occurs in 12–25% of patients affected by UC. Patients with ASC should be managed by a mul-

tidisciplinary team. Aggressive medical or surgical treatment is undertaken with the final aim of reducing mortality. Intravenous

corticosteroids are the mainstay of therapy. Medical rescue therapy based on cyclosporine or infliximab should be considered if

there is no response to corticosteroids after 3 days. In the event that there has been no response to medical rescue therapy after

4–7 days, the patient must undergo urgent colectomy surgery. Prolonged observation is counterproductive as over time it increases

the risk of toxic mega colon and of perforation burdened with a very high mortality rate.

Conclusions:

The best possible treatment is represented by subtotal colectomy with ileostomy and preservation of a long rectal

stump. Emergency colectomy is characterized by high morbidity and low mortality rates.