Bobbio P, Zola C, Salcuni P
Ateneo Parmense Acta Biomed. 1977;48(2):93-100.
During the last 12 years 7 patients with ulcerative colitis were treated because of an acute complication consisting in 2 cases of colonic perforation, 3 cases of toxic megacolon (two of them perforated) and 2 cases of massive enterorragia. In all patients an emergency total colectomy was performed resulting a mortality of 3 cases, two of which had required the removal in a second time of the rectal stump. In 3 or 4 recovered patients we performed in a period of 7-15 months an ileo-proctostomy once confirmed the healing of the ulcerative lesions in the residual rectum. The problems concerning the indications and surgical procedures involved in such cases are discussed on the base of the personal experience, with particular consideration on advantages and limits of preserving a rectal stump. The authors agree on an eclectic behavior considering each case on the base of pathological findings, the age and the general and psychic conditions of the single patient.
在过去12年中，7例溃疡性结肠炎患者因急性并发症接受治疗，其中包括2例结肠穿孔、3例中毒性巨结肠（其中2例穿孔）和2例大量肠出血。所有患者均接受了急诊全结肠切除术，导致3例死亡，其中2例需要再次切除直肠残端。在3或4例康复患者中，在7至15个月的时间内，一旦确认残留直肠的溃疡性病变愈合，就进行了回肠直肠吻合术。根据个人经验讨论了此类病例的适应症和手术方法相关问题，特别考虑了保留直肠残端的优点和局限性。作者们一致认为应采取折衷的做法，根据病理结果、年龄以及单个患者的一般和心理状况来考虑每一个病例。
