Related Experiment Videos
Surgical management of pseudomembranous colitis
S J Bradley1, D W Weaver, N P Maxwell
1Department of Surgery, Wayne State University, Detroit, Michigan.
The American Surgeon
|June 1, 1988
Summary
Surgical intervention for pseudomembranous colitis (PMC) is recommended if medical management fails after 7 days. Subtotal colectomy with ileostomy offers the best outcomes for refractory PMC, toxic megacolon, and perforation.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Pseudomembranous colitis (PMC) is a severe intestinal condition.
- Surgical management guidelines for PMC are not well-established.
Observation:
- A review of 21 surgical cases of PMC was conducted.
- Indications for surgery included refractory disease, toxic megacolon, and perforation.
- Surgical approaches varied from decompressive cecostomy to total proctocolectomy.
Findings:
- Subtotal colectomy with ileostomy yielded the best surgical outcomes.
- PMC management should parallel that of ulcerative colitis.
- Early surgical intervention is crucial for severe or complicated PMC.
Implications:
- Aggressive medical management for PMC should not exceed 7 days before considering surgery.
- Ileostomy with subtotal colectomy is the preferred approach for refractory PMC, toxic megacolon, and perforation.
- Simple decompression or segmental resection is inadequate for altering the disease process in complicated PMC.