1977 Volume 30 Issue 1 Pages 25-32,94
The ulcerative colitis is characterized in a chronic inflammation and ulcerative change involving the diffuse region of the colon and rectum. It's typical type is easily diagnosed by x-ray and endoscopy, but it is still difficult to differentiate its atypical type from other nonspecific inflammatory colonic disease.
The first case is a 54-year-old male and he visited us complaining of massive hematochesia. In the endoscopic finding, mucosal hypermia, edema and bleeding were remarkable but pseudopolyposis was not clear. In this case, conservative treatment including steroid administration was not effective and surgical treatment was performed. On examination of the excised specimen, it did not show a typical change of ulcerative colitis.
The second case is a 45-year-old male. The patient complained of bloody stool and severe diarrhea over 20 times a day. In this course, anorexia and melena became remarkable with diarrhea. The most cparacteristic findings of the endoscope inserted 10 cm from the anal verge was hemorrhagic-mucopuriilent discharge and hyperemic swelling of the mucosal membrane.
The diagnosis of fulminant ulcerative colitis depends upon the clinical features, abnormal biochemial findings, and the romonscopic findings was performed, Intausive conservatic mauagent was not successful in this patint and dead in the sixth day. Gallagher described the management of patients with fulminant ulcerative colitis, of which 22 cases undewent early surgery with 9% mortality rate.
Prolonged conservative therapy or delayed surgery were resulted in 61% mortality rate. In an attemp to lessen mortality, colectomy should be recommended at an early stage of the illness if no prompt improvement occured with conservative therapy.
