[Treatment and outcome of severe ulcerative colitis with mucosal undermining on X-rays (author's transl)]

The authors present a retrospective study of 11 patients who had suffered from a severe attack of ulcerative colitis with extensive undermining of the mucosa on barium enema. All patients were given corticosteroids and antibodies. Oral feeding was suspended in 7, and 3 received exclusive parenteral nutrition. In 2 cases medical treatment resulted in complete remission, but 9 patients underwent surgery (total proctocolectomy in 4, total colectomy with ileo-rectal anastomosis in 3, colostomy in 1 and exploratory laparotomy in 1). Six of the operated patients were followed up for 1 to 7 years and are now in good health; the remaining three died early in the post-operative period. Extensive mucosal undermining in ulcerative colitis is a factor of poor prognosis.