%0 Journal Article
%T Evolutionary Profile of Severe Acute Ulcerative Colitis in Chronic Inflammatory Bowel Diseases
%A Hakima Abid
%A Fatima Babakhouya
%A Ihssane Mellouki
%A Mounia El Yousfi
%A Noureddine Aqodad
%A Dafr Allah Benajah
%A Adil Ibrahimi
%A Mohamed El Abkari
%J Open Journal of Gastroenterology
%P 107-117
%@ 2163-9469
%D 2018
%I Scientific Research Publishing
%R 10.4236/ojgas.2018.83012
%X <strong>Background:</strong> Severe acute colitis is a common complication of inflammatory bowel disease (IBD). Their diagnosis is based on clinical, laboratory, endoscopic and radiological. The severe acute colitis is a medical and surgical emergency; its mortality is 1% to 3%. The management should be swift and coordinated, upon admission, between medical and surgical teams. <strong>Methods:</strong> This is a retrospective study in Gastroenterology Service at the University Hospital HASSAN II Fez, over a period of 10 years (2005-2015). We included all patients admitted for severe acute colitis; all the epidemiological, clinical, endoscopic, histological, and therapeutic monitoring of patients were collected. <strong>Results:</strong> We collected 123 patients. Their average age was 35 years (16 - 70). It was a female predominance (sex ratio F/M = 1.19). 54 patients were admitted for an inaugural severe acute colitis (43%), while 69 patients were known carriers of IBD (56%). All patients were admitted to an array of severe acute colitis according to the criteria of Truelove and Witts modified. 9 patients were operated urgently because there was the presence of complications (5 cases of perforation, 3 cases of massive rectal bleeding, and one patient with an abscess in the right iliac fossa). Corticosteroids intravenously was administered to 114 patients, 74 patients (64%) had remission. Patients who have not responded to corticosteroids IV (N = 40): 1) 12 patients received treatment with oral cyclosporine: the remission rate was 66%. 2) 8 patients were put under Infliximab: The response rate was 75%. 3) Patients who have not responded to a second-line treatment underwent subtotal colectomy with a dual stoma. 4) The surgery was indicated as a second-line treatment in 20 patients who all received a subtotal colectomy with double stoma; totalizing colectomy and ileoanale anastomosis ware made in 4 patients. The mortality rate is higher in our series (12%) mainly postoperatively; it is due to the delayed admission of patients, which promotes the development of complications. <strong>Conclusion:</strong> Acute Severe Ulcerative Colitis is a medical and surgical emergency that requires a multidisciplinary approach; medical treatment is the basis of initial treatment; but surgery must always be indicated at the right time avoiding increasing the death rate, this rate is important in our series.
%K Acute Severe Ulcerative Colitis
%K Infliximab
%K Cyclosporine
%K Colectomy
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=83468