Premium
ULCERATIVE COLITIS: THE EXPERIENCE OF A SYDNEY TEACHING HOSPITAL
Author(s) -
Gillies Margaret,
Skyring Alan
Publication year - 1970
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1970.tb78035.x
Subject(s) - medicine , ulcerative colitis , perforation , disease , colectomy , carcinoma , gastroenterology , hepatocellular carcinoma , surgery , punching , materials science , metallurgy
A retrospective study of 438 patients treated for ulcerative colitis at the Royal Prince Alfred Hospital, Sydney, revealed that at 15 years the probability of survival for persons with universal disease was 0.50, for surgery 0.82 and for developing carcinoma 0.14. Left‐sided disease and rectosigmoiditis carried a better overall prognosis. Sixty‐three patients had histological evidence of liver disease; pericholangitis was found in 40 patients; 10 patients had active chronic hepatitis; and in 13 patients the liver was infiltrated with fat. Twenty patients developed colonic carcinoma, three had biliary carcinoma, and one had carcinoma of both colon and biliary tree. Eighty‐five patients were severely ill with profuse diarrhoea, abdominal pain and In 10 cases colonic perforation. Fifty‐five such patients required colectomy after they had failed to respond to fluid, electrolyte and blood replacement, corticosteroids and antibiotics. The experience reported indicates that the major problems in management of patients presenting to hospital are those associated with continuous disease, acute attacks, and carcinoma or the fear of its development. The value of early operation on young persons with universal disease is discussed.