RESUMO
La colitis ulcerativa aguda severa es una urgencia médica que puede comprometer la vida del paciente; requiere una alta sospecha diagnóstica para establecer un manejo adecuado y oportuno, y prevenir complicaciones. Es necesario determinar factores pronósticos para identificar pacientes de alto riesgo. Los esteroides intravenosos son tratamiento de primera línea, en caso de no respuesta, el uso de terapia de "rescate" con infliximab o ciclosporina reduce el riesgo de colectomía a corto plazo, sin comprometer la seguridad del paciente.
Acute severe ulcerative colitis is a potentially life-threatening condition that requires a pro-active approach with either effective medical treatment or timely colectomy. It is very important to identify at an early stage those who are likely to fail intensive treatment. Although intravenous steroids remain the first line, for those who fail, currently available 'rescue' medical therapy with infliximab and cyclosporine may reduce the risk of colectomy in the short term without compromising safety.