Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2019, Vol. 41 ›› Issue (4): 452-456.doi: 10.3881/j.issn.1000-503X.10733

• Original Articles • Previous Articles     Next Articles

Clinical Features and Outcomes of Ulcerative Colitis Complicated with Acute Massive Lower Gastrointestinal Hemorrhage

LIU Huiting1,LI Ji1(),DONG Xuyang1,Lü Hong1,YANG Hong1,LI Yue1,SHU Huijun1,SUN Xiyu2,WU Bin2,QIAN Jiaming1   

  1. 1 Department of Gastroenterology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
    2 Department of General Surgery,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
  • Received:2018-07-24 Online:2019-08-30 Published:2019-09-05
  • Contact: Ji LI E-mail:liji0235@pumch.cn
  • Supported by:
    Supported by Special Foundation for Scientific Research in Health Industry(201002020);2017 Teaching Quality Improving Project of Peking Union Medical Collage(2017zlgc0110)

Abstract:

Objective To analyze the clinical features and prognosis of ulcerative colitis(UC)complicated with acute massive lower gastrointestinal bleeding(LGIB). Methods Eleven patients hospitalized in Peking Union Medical College Hospital from January 2006 to December 2017 for treatment of UC,suffering from acute massive LGIB,were enrolled and descriptively analyzed. Results The proportion of UC patients with acute massive LGIB was 0.7% among all 1486 UC patients hospitalized during the study period.The disease was moderately or severely active in these 11 patients,among whom 9 patients(81.8%)had chronic relapsing pancolitis.Cytomegalovirus infection was present in 5 patients,among whom 4 patients received antiviral treatments.All the 11 patients received treatments including food and water fasting,rehydration,blood transfusion,and use of somatostatin.Four patients received emergency surgical treatment after the first episode of massive bleeding,and 3 of them suffered from re-bleeding after the surgery.Among the remaining seven patients,two underwent emergency total colectomy+subtotal rectectomy+ileostomy and three received elective total resection of colon and rectum or total colectomy+subtotal rectectomy+ileostomy.Thus,9 patients underwent emergency surgery,1 patient did not receive surgey during follow-up,and 1 patient was lost to follow-up. Conclusions Acute massive LGIB is a manifestation of active UC and can be associated with poor prognosis.Optimized perioperative management is important for improving the outcomes of such patients.

Key words: ulcerative colitis, acute massive lower gastrointestinal bleeding, cytomegalovirus infection, postoperational bleeding

CLC Number: