Indications of surgery in ulcerative colitis

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Presentation transcript:

Indications of surgery in ulcerative colitis Dr. Maryam SAEI NAEIMI KISH- 18 ESFAND 1395

The Overall Incidence of Colectomy in a UC Patient Ranges from 23% to 45%

Incidication for Colectomy Acute flare unresponsive to medical measures Intravenous Steroid Bowel Rest Parenteral hyper alimentation Cyclosporine

Development of a Life-threatening complications Toxic colitis Perforation Hemorrhage

Medical intractability Is the most common indication for operation and may seem difficult to define. 12 months of Steroids or other immunosuppressive management without complete resolution of symptoms is an adequate medical trial.

Risk of Malignancy The risk of cancer is relatively low for the first 10 years after disease onset then begins to increase at a rate of 1%-2% per year. Low grade dysplasia High grade dysplasia Carcinoma

Disabling extra colonic disease Arthritis Uveitis or Iritis Primary sclerosing cholangitis Ankylosing spondylitis Sacroiliitis Pyoderma gangrenosum

Growth retardation in children Steroid therapy Inadequate protein intake and excess loss in the colon Rapid growth spurt is often observed after definitive surgery.