Total Proctocolectomy and Ileostomy: Procedure of Choice for Acute Toxic Megacolon

Kenneth R. Sirinek, Carl E. Tetirick, Neil R. Thomford, William G. Pace

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Of 42 critically ill patients with toxic megacolon, 31 required emergency surgery, and 11 were treated without operation. Of the 11 patients treated by medical measures alone, there were two deaths (18%): one early, secondary to undiagnosed colonic perforation, and one late death from recurrent ulcerative colitis. Nine of ten survivors (90%) experienced continued morbidity, and five (50%) required subsequent elective surgery. Thirty-one patients required emergency operation for failure of medical treatment (19), colonic perforation (ten), and uncontrolled hemorrhage (two). Early and late morbidity was 74% (two-thirds occurring after subtotal colectomy and ileostomy). Surgical mortality was 19% (8% over the last ten years). (Arch Surg 112:518-522, 1977).

Original languageEnglish (US)
Pages (from-to)518-522
Number of pages5
JournalArchives of Surgery
Volume112
Issue number4
DOIs
StatePublished - Apr 1977
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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