scholarly journals Management of Severe Attacks of Ulcerative Colitis with New Technologies

1990 ◽  
Vol 4 (7) ◽  
pp. 347-349
Author(s):  
M Campieri ◽  
P Gionchetti ◽  
A Belluzzi ◽  
M Tampieri ◽  
C Brignola ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Transverse Colon ◽  
Bowel Wall ◽  
New Technologies ◽  
Toxic Megacolon ◽  
Abdominal Ultrasound ◽  
Histological Evaluation ◽  
Excellent Correlation ◽  
Severe Ulcerative Colitis ◽  
Descending Colon

Barium enema and colonoscopy are contraindicated in severe attacks of ulcerative colitis because of the possibility of toxic megacolon and perforation. The authors have assessed abdominal ultrasound in 38 patients with severe ulcerative colitis. Ultrasound revealed bowel wall thicknesses ranging from 3.9 to 9.2 mm (mean 7.7) extending the whole length of the colon, to the transverse colon, and to the descending colon, respectively, in 18, 10 and eight patients. The degree of bowel thickening was related to the severity of inflammation based on clinical, sigmoidoscopic and histological evaluation. In two patients, ultrasound showed a thin bowel wall distended without motility, suggesting the diagnosis of toxic megacolon (confirmed radiologically). An excellent correlation (95%) was found between ultrasound and technetium-99 scanning. Ultrasound might be a reasonable first investigation in the assessment of patients with severe ulcerative colitis.

scholarly journals Intestinal ultrasound for monitoring therapeutic response in patients with ulcerative colitis: results from the TRUST&UC study

Gut ◽  
2019 ◽  
Vol 69 (9) ◽  
pp. 1629-1636 ◽  
Author(s):  
Christian Maaser ◽  
Frauke Petersen ◽  
Ulf Helwig ◽  
Imma Fischer ◽  
Alexander Roessler ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Disease Activity ◽  
Sigmoid Colon ◽  
Therapeutic Response ◽  
Bowel Wall ◽  
Activity Index ◽  
Point Of Care ◽  
Clinical Relapse ◽  
Short Term Treatment ◽  
Descending Colon

ObjectiveProspective evaluation of intestinal ultrasound (IUS) for disease monitoring of patients with ulcerative colitis (UC) in routine medical practice.DesignTRansabdominal Ultrasonography of the bowel in Subjects with IBD To monitor disease activity with UC (TRUST&UC) was a prospective, observational study at 42 German inflammatory bowel disease-specialised centres representing different care levels. Patients with a diagnosis of a proctosigmoiditis, left-sided colitis or pancolitis currently in clinical relapse (defined as Short Clinical Colitis Activity Index ≥5) were enrolled consecutively. Disease activity and vascularisation within the affected bowel wall areas were assessed by duplex/Colour Doppler ultrasonography.ResultsAt baseline, 88.5% (n=224) of the patients had an increased bowel wall thickness (BWT) in the descending or sigmoid colon. Even within the first 2 weeks of the study, the percentage of patients with an increased BWT in the sigmoid or descending colon decreased significantly (sigmoid colon 89.3%–38.6%; descending colon 83.0%–42.9%; p<0.001 each) and remained low at week 6 and 12 (sigmoid colon 35.4% and 32.0%; descending colon 43.4% and 37.6%; p<0.001 each). Normalisation of BWT and clinical response after 12 weeks of treatment showed a high correlation (90.5% of patients with normalised BWT had symptomatic response vs 9.5% without symptomatic response; p<0.001).ConclusionsIUS may be preferred in general practice in a point-of-care setting for monitoring the disease course and for assessing short-term treatment response. Our findings give rise to the assumption that monitoring BWT alone has the potential to predict the therapeutic response, which has to be verified in future studies.

scholarly journals Two Cases of Severe Ulcerative Colitis with Colonic Dilatation Resolved with Tacrolimus Therapy

2015 ◽  
Vol 9 (2) ◽  
pp. 272-277
Author(s):  
Ryohei Hayashi ◽  
Yoshitaka Ueno ◽  
Shinji Tanaka ◽  
Shintaro Sagami ◽  
Kenta Nagai ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Abdominal Pain ◽  
Corticosteroid Therapy ◽  
Transverse Colon ◽  
Intestinal Tract ◽  
Rescue Therapy ◽  
Severe Ulcerative Colitis ◽  
X Ray ◽  
Emergency Colectomy ◽  
Tacrolimus Therapy

We report 2 cases of ulcerative colitis (UC) with intestinal tract dilatation treated with tacrolimus. They were 53- and 64-year-old males, who had been admitted to local hospitals for increasing severity of their UC symptoms. Treatment for severe UC was immediately started, but both cases were refractory to corticosteroid therapy; they were then transferred to our hospital. When they were referred to our hospital, they had frequent bloody diarrhea, fever, severe abdominal pain, and even dilatation of the transverse colon on abdominal X-ray test. They were treated with oral tacrolimus medication, and their symptoms improved immediately. Dilatation of the transverse colon was improved on plain X-ray at 2 weeks after starting therapy, and emergency colectomy could be avoided. These 2 cases may suggest that tacrolimus is effective for UC with colonic dilatation as a rescue therapy.

PP65 ULTRASOUND SCAN WITH BOWEL WALL THICKNESS EXAMINATION, IN ACUTE SEVERE ULCERATIVE COLITIS IN CHILDREN

2011 ◽  
Vol 43 ◽  
pp. S436
Author(s):  
A. Montemaggi ◽  
L. Tasciotti ◽  
M. Basile ◽  
M. De Maurizio ◽  
M. Paci ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Wall Thickness ◽  
Bowel Wall ◽  
Ultrasound Scan ◽  
Severe Ulcerative Colitis ◽  
Bowel Wall Thickness

scholarly journals Surgery for Severe Ulcerative Colitis during Pregnancy: Report of Two Cases

2015 ◽  
Vol 9 (1) ◽  
pp. 74-80 ◽  
Author(s):  
Motoi Uchino ◽  
Hiroki Ikeuchi ◽  
Hiroki Matsuoka ◽  
Toshihiro Bando ◽  
Kei Hirose ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Cesarean Section ◽  
Disease Severity ◽  
Gestational Age ◽  
Surgical Procedure ◽  
Conservative Therapy ◽  
Toxic Megacolon ◽  
Maternal Complications ◽  
Severe Ulcerative Colitis ◽  
History Of

Refractory ulcerative colitis (UC) that does not respond to medical therapy often requires surgery even during pregnancy. Although surgical cases of UC during pregnancy were reported previously, the standard surgical strategy for both colitis and pregnancy was unclear. Herein, fetal and maternal safety as well as the strategy for this unusual surgical procedure during pregnancy in patients with UC are considered. A 28-year-old woman was diagnosed with left-sided moderate UC at 12 weeks of pregnancy; toxic megacolon was suspected, and surgery was required. Although the baby's gestational age was 23 weeks and 3 days, a cesarean section was performed before the colectomy. In a next case, a 28-year-old woman had a 2-year history of left-sided UC. Her colitis flared up at 11 weeks of pregnancy. Colectomy was performed because her colitis was unresponsive to conservative therapy, and the pregnancy was continued, with a transvaginal delivery at 36 weeks. In patients with UC, the need for surgery should be determined promptly based on disease severity, whether or not the patient is pregnant. The need for surgery should not be affected by pregnancy. The pregnancy should be continued for as long as possible when there are no fetal and maternal complications. Both cesarean section and colectomy should be performed independently if necessary.

scholarly journals Toxic megacolon and human Cytomegalovirus in a series of severe ulcerative colitis patients

2015 ◽  
Vol 66 ◽  
pp. 103-106 ◽  
Author(s):  
Valeria Criscuoli ◽  
Maria Rosa Rizzuto ◽  
Elena Gallo ◽  
Ambrogio Orlando ◽  
Mario Cottone
Keyword(s):  
Ulcerative Colitis ◽  
Human Cytomegalovirus ◽  
Toxic Megacolon ◽  
Severe Ulcerative Colitis
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