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Download 18 ESFAND 1395 The Overall Incidence of Colectomy in a UC
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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% A. Incidication for Colectomy 1) Acute flare unresponsive to medical measures Intravenous Steroid Bowel Rest Parenteral hyper alimentation Cyclosporine 2) Development of a Life-threatening complications Toxic colitis Perforation Hemorrhage 3) 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. 4) 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 5) Disabling extra colonic disease Arthritis Uveitis or Iritis Primary sclerosing cholangitis Ankylosing spondylitis Sacroiliitis Pyoderma gangrenosum 6) Growth retardation in children Steroid therapy Inadequate protein intake and excess loss in the colon Rapid growth spurt is often observed after definitive surgery.
