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Surgery for fulminating colitis during pregnancy.

M G Bohe, G R Ekelund, S N Genell

    Diseases of the Colon and Rectum
    |February 1, 1983
    PubMed
    Summary
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    [Collagenous colitis].

    Leber, Magen, Darm·1991

    Fulminating colitis during pregnancy requires surgical intervention, including colectomy and ileostomy or proctocolectomy, often combined with cesarean section. Histopathology confirmed Crohn's disease in both reported cases of severe colitis during gestation.

    Area of Science:

    • Gastroenterology
    • Obstetrics and Gynecology
    • Surgical Gastroenterology

    Background:

    • Fulminating colitis is a severe gastrointestinal condition that can present during pregnancy, posing significant risks to both mother and fetus.
    • Management of severe colitis during pregnancy is complex, often necessitating multidisciplinary approaches involving obstetricians and surgeons.

    Purpose of the Study:

    • To describe two cases of fulminating colitis during pregnancy.
    • To evaluate the surgical management and outcomes of severe colitis in pregnant patients.
    • To determine if treatment for fulminating colitis during pregnancy should differ from nonpregnant individuals.

    Main Methods:

    • Case report of two pregnant patients with fulminating colitis.
    • Surgical intervention including subtotal colectomy with ileostomy and proctocolectomy.

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  • Cesarean section performed during pregnancy or in the puerperium.
  • Histopathologic examination to determine the etiology of colitis.

    • Main Results:

    • Both patients underwent cesarean section and subsequent resectional surgery for colitis.
    • The first patient had a cesarean section combined with subtotal colectomy and ileostomy at 32 weeks' gestation.
    • The second patient had a cesarean section at 33 weeks' gestation followed by proctocolectomy in the puerperium.
    • Histopathology in both cases indicated Crohn's disease as the cause of colitis.

    Conclusions:

    • Fulminating colitis during pregnancy can be managed with resectional surgery, similar to nonpregnant patients.
    • Surgical intervention, including colectomy and ileostomy or proctocolectomy, can be safely performed during pregnancy or the puerperium.
    • Crohn's disease should be considered in the differential diagnosis of fulminating colitis presenting during pregnancy.