Volume : 3, Issue : 5, May - 2014

Surgical Approaches in Fulminant Ulcerative Colitis

Corina Silvia Pop, Roxana Maria Nemes, George Pariza

Abstract :

We report a case of a 43–year old women with a 6–year history of ulcerative colitis presents with a week high–grade fever, myalgia, joint pain, headache and cough.She has been in treatment with TNF–alfa antagonist for 1 year, for severe left–sided colitis. Was admitted in the hospital and physical examination reveals a feile patient, 390 C, tachycardia 100 beats/min, tachypnea 28/min. Despite this vigoruos treatment measures (nasoenteric tube, parenteral nutrition, intravenous fluid and electrolyte replacement, intravenous steroid–metylprednisolone and a dose of infliximab), the outcome was not favorable, clinical condition has worsened and a plain abdominal radiography and abdominal CT shows important transverse and cecum distension witch contains large amounts of fluid and air.Toxic megacolon represent a major potentially life–threatening complication of ulcerative (pan)colitis . An important and difficult aspect is to decide the optimal time for surgical intervention.Surgery was life–saving for this patient.