How district hospitals see acute colitis

Acute colitis was an uncommon cause of admission to twenty-two district hospitals in 1975--77. The overall mortality in this series of 130 patients was 5.2%, 1.8% during medical treatment and 20% after urgent surgical treatment. A third of the patients were admitted without previous diagnosis. Four-fifths responded to medical treatment and the rest were treated by urgent colectomy. Four of the six related deaths and half the urgent operations occurred among 18 patients iwth colonic dilatation. This complication was often detected within two days of admission by abdominal X-ray; symptoms and signs were unhelpful in its recognition. Early admission to hospital of patients with severe unexplained diarrhoea or a sharp attack of colitis, rapid investigation to exclude infection, and energetic treatment of colitis, monitored by abdominal X-rays to detect colonic dilatation at its earliest stage, might reduce the frequency and danger of this complication.