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[Toxic colitis. II. Personal experience]

F Antos1

  • 1Chirurgická katedra IPVZ, FN Na Bulovce, Praha.

Rozhledy V Chirurgii : Mesicnik Ceskoslovenske Chirurgicke Spolecnosti
|May 1, 1995
PubMed
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Early surgical intervention for toxic colitis, particularly subtotal colectomy, is crucial for survival. Delayed surgery (5-7 days) correlates with higher mortality, while earlier or later operations show no deaths. This study highlights the importance of timely surgical management in toxic colitis cases.

Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Clinical Medicine

Context:

  • Presents clinical experience with 19 patients diagnosed with acute toxic colitis.
  • Identifies ulcerative colitis and pseudomembranous colitis as primary underlying conditions.
  • Highlights limitations of conservative treatment initiated after 72 hours.

Purpose:

  • To evaluate the efficacy of surgical intervention in managing acute toxic colitis.
  • To determine the optimal timing for surgical intervention to reduce mortality.
  • To report on outcomes including mortality and incidental findings such as carcinoma.

Summary:

  • 17 out of 19 patients with toxic colitis underwent subtotal colectomy with ileostomy and rectosigmoid mucous fistula.
  • Mortality rate was 10.5% (2 deaths), both occurring in patients operated between the 5th-7th day of illness.

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  • No deaths were observed in patients operated between days 2-5 or days 14-21, suggesting improved outcomes with earlier or delayed intervention compared to intermediate timing.
  • Two cases of colorectal carcinoma were incidentally detected during the study period.

    • Impact:

    • Provides evidence supporting timely surgical intervention in toxic colitis management.
    • Suggests that surgical timing significantly influences patient outcomes and mortality.
    • Underscores the need for careful consideration of surgical timing in acute toxic colitis cases to improve survival rates.