Emergency surgery in ulcerative colitis.

Ulcerative colitis in its milder manifestations may be managed by conservative methods. If these are unsuccessful, or, in the presence of more severe disease, a planned surgical procedure, either subtotal colectomy or proctocolectomy, is the alternative method of treatment. On occasion, however, the rapidity of progression of the disease forces the issue: conservative measures, if any have been instituted, have to be abandoned, and emergency surgery becomes obligatory. The results of such surgery are markedly worse in terms of mortality than interval or definitive procedures (Tables I and II). One possible method of improving this serious discrepancy between interval and emergency surgery could be an earlier resort to surgery in certain situations. This paper presents an analysis of a group of patients with ulcerative colitis treated by emergency surgery because there was marked clinical deteriora-