Ewerwahn W J, Winkler R
Dtsch Med Wochenschr. 1977 Jun 10;102(23):860-5. doi: 10.1055/s-0028-1104978.
Among 195 patients with ulcerative colitis 30 had acute complications--toxic megacolon with or without perforations. In 16 primary treatment consisted of proctocolectomy in one stage: all patients died. Since 1971, 14 were treated by primary multiple enterostomies, with only three deaths. Indications for the latter procedure are given if after 48-72 hours of conservative treatment there is no response. Definitive treatment consists, almost without exception, of secondary proctocolectomy during the period of remission. Indications for the two-stage procedure should be extended to all acute cases requiring operation.
在195例溃疡性结肠炎患者中，30例出现急性并发症——中毒性巨结肠伴或不伴穿孔。16例患者的一期治疗为全结肠直肠切除术：所有患者均死亡。自1971年以来，14例患者接受了一期多处肠造口术治疗，仅3例死亡。如果在保守治疗48 - 72小时后无反应，即可采用后一种手术方法。最终治疗几乎无一例外是在缓解期进行二期全结肠直肠切除术。两期手术的适应证应扩大到所有需要手术的急性病例。
