[Exceptional clinical courses of granulomatous colitis in children and adolescents (author's transl)].

Acute complications are known in chronic ulcerative colitis as well as in Crohn's colitis. They can rarely be seen also in childhood and adolescence. Massive rectal bleeding, particularly acute toxic dilatation of the large bowel should be treated surgically after a short-term medical therapy. The procedure of choice is the one stage proctocolectomy. Alternatively the method described by TURNBULL performing a loop ileostomy and several colostomies can be used. Besides the clinical symptoms and signs more than 8 stools and a temperature of more than 38 degrees C in the first 24 hours of hospitalisation can predict a severe clinical course.