THE RESULTS OF TREATMENT OF IDIOPATHIC ULCERATIVE COLITIS IN A DEPARTMENT OF SURGERY

Clinical features and the results of treatment in 61 cases of ulcerative colitis (34 males and 27 females) were analyzed. In most of the cases (47 cases, or 77%), the age at which the disease occurred was estimated to be between 10 and 39 years. Early complaints were mucous bloody stools (seen in 77% of all cases), diarrhea (66%) and abdominal pain (23%). Fifty patients were treated medically and 11 were treated surgically (urgent or semi-urgent surgery in 4 cases and non-urgent surgery in 7 cases). Of the 4 patietns who underwent urgent or semi-urgent surgery, 2 had perforations and the other 2 had fulminant type ulcerative colitis. The fatality rate for these 4 patients was 50%. Of the 7 patients who underwent non-urgent surgery, 4 had been treated medically for less than 5 years; in these 4 cases, the active stage occupied more than 50% of the total observation period, and the average relapse frequency was over 1.3 times per year. The other two patients, who underwent non-urgent surgery, had been treated medically for more than 5 years; they had been treated with more than 10, 000 mg of Predonine (prednisolone acetate) and it was difficult to discontinue their steroid therapy. Carcinogenesis was seen in one patient who had a relapsing-remitting type of ulcerative colitis which affected the entire large intestine and which had initially occurred 24 years earlier (this gave an incidence of carcinogenesis of 1.6%). The results of this study suggest that patients with severe ulcerative colitis (including the fulminant type) should be surgically treated in time rather than adhering to conservative treatment, in order to reduce the current high mortality rate during or following urgent surgery.