[Emergency colectomy in ulcerative colitis (author's transl)]

During the last 12 years 7 patients with ulcerative colitis were treated because of an acute complication consisting in 2 cases of colonic perforation, 3 cases of toxic megacolon (two of them perforated) and 2 cases of massive enterorragia. In all patients an emergency total colectomy was performed resulting a mortality of 3 cases, two of which had required the removal in a second time of the rectal stump. In 3 or 4 recovered patients we performed in a period of 7-15 months an ileo-proctostomy once confirmed the healing of the ulcerative lesions in the residual rectum. The problems concerning the indications and surgical procedures involved in such cases are discussed on the base of the personal experience, with particular consideration on advantages and limits of preserving a rectal stump. The authors agree on an eclectic behavior considering each case on the base of pathological findings, the age and the general and psychic conditions of the single patient.