علاج القولون السام في التهاب القولون التقرحي الحاد الشديد مع أكثر من ست حركات أمعاء دموية يومياً

References

1. Acute severe ulcerative colitis (ASUC), historically referred to as "fulminant" or "toxic" colitis, represents a severe form of acute colitis involving more than six bloody stools per day accompanied by at least one systemic sign of toxicity including tachycardia, fever, anemia (hemoglobin <10.5 g/dL), or elevated erythrocyte sedimentation rate (ESR) greater than 30 mm/h.
2. Patients with severe medically refractory ASUC, TM, massive hemorrhage, or colonic perforation should undergo surgical therapy.
3. The operation of choice continues to be subtotal abdominal colectomy with end ileostomy.
4. To prevent rectal stump dehiscence and leak, most surgeons elect to leave a transanally placed rectal tube for decompression.
5. While decompressive procedures alone carry a significant morbidity when compared with subtotal colectomy and end ileostomy, a Turnbull blowhole colostomy can be considered in patients with prohibitive comorbidities, a hostile abdomen, or a pregnant patient with acute severe colitis.