The importance of early surgery in children with ulcerative colitis.

Abstract

BACKGROUND:

Ulcerative colitis begins in early childhood in 4% of cases. Medical therapy is non-specific, and as many as 70% of children will ultimately require surgery. The dynamic growth, physical and psychological changes that characterize childhood are severely compromised by the complications of ulcerative colitis and its therapy.

OBJECTIVE:

To review the outcome of children undergoing early surgery for ulcerative colitis at a tertiary medical center in Israel.

METHODS:

A retrospective review was conducted of all children operated on following failure of medical therapy for ulcerative colitis during a 5 year period.

RESULTS:

Eleven children underwent a J-pouch procedure with ileo-anal anastomosis in one to three stages. Postoperative complications included recurrent pouchitis in 5 patients, intestinal obstruction in 3, fistula with incontinence in one, stricture in one, and wound infection in 4. Follow-up revealed that most of the patients have three to four soft bowel movements daily. All currently enjoy normal physical activities and a rich social life.

CONCLUSIONS:

The quality of life in children with ulcerative colitis was markedly improved following J-pouch surgery. This procedure was not associated with major complications. We recommend early surgery as an alternative to aggressive medical therapy in children with this disease.

• Authors: H Nagar, M Rabau
• Journal: The Israel Medical Association journal : IMAJ (Isr Med Assoc J) Vol. 2 Issue 8 Pg. 592-4 (Aug 2000) ISSN: 1565-1088 [Print] Israel
• PMID: 10979351 (Publication Type: Journal Article)

Topics

• Adolescent
• Child
• Colitis, Ulcerative (surgery)
• Female
• Humans
• Male
• Postoperative Complications
• Proctocolectomy, Restorative
• Quality of Life
• Time Factors