COLONOSCOPY FOR THE ASSESSMENT OF ACUTE ULCERATIVE COLITIS

Abstract

Seventy-five severe or moderately severe patients with ulcerative colitis had been treated from 1994 to 1999 in our department. There were 49 males, 26 females with the mean age of 37 years, consisting of 38 patients with total colitis, 37 patients with left-sided colitis. Twelve patients were with first attack, 55 patients with relapsing-remitting type and 6 patients with chronic persisting type. Twelve of these 75 patients underwent emergency operation because of no response to the treatment, massive colo-rectal hemorrhage, or toxic dilatation of the colon. Extent and whether first attack or relapse may help to consider surgical indication. Presence of polypoid mucosal tag and large mucosal abrasion were the good predictive factors for evergency operation. Endoscopic severity was significant predictive factors between those responded to medication and those did not respond. Colonoscopic examination is safe and gives valuable information in deciding early colectomy of severe colitic patients.