| Management of acute, severe ulcerative colitis. | |
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MedLine Citation:
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PMID: 22257473 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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When a patient is hospitalized with acute, severe ulcerative colitis, the primary decision is whether or not to proceed directly to surgery. Absolute indications for an immediate colectomy include exsanguinating hemorrhage, perforation and cancer. If medical therapy is undertaken, however, the decision for urgent surgery or non-operative salvage therapy will still be required in 15-50% of the patients in which there is a failure to respond within 3-5 days to a standard regimen of i.v. steroids, antibiotics, decompressive maneuvers, fluid and electrolyte replacement and other supportive measures. The options for medical salvage therapy are usually cyclosporine or infliximab. There are theoretical and practical arguments on each side; the current GETAID and CONSTRUCT trials will probably provide support for either. The choice between colectomy or medical salvage therapy, however, must not be delayed under any circumstances. Before choosing salvage therapy, one must first be certain that there is the luxury of time, that there is a post-hospital strategy for the maintenance of remission and that the colon is worth saving. The priority is not so much saving colons as it is saving lives. |
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Authors:
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David B Sachar |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of digestive diseases Volume: 13 ISSN: 1751-2980 ISO Abbreviation: J Dig Dis Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-01-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101302699 Medline TA: J Dig Dis Country: Australia |
Other Details:
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Languages: eng Pagination: 65-8 Citation Subset: IM |
Copyright Information:
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© 2012 The Author. Journal of Digestive Diseases © 2012 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Blackwell Publishing Asia Pty Ltd. |
Affiliation:
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Division of Gastroenterology, Department of Medicine, Mount Sinai School of Medicine, New York, NY, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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