Optimal management of acute severe ulcerative colitis in children / 中华实用儿科临床杂志

ABSTRACT

Acute severe ulcerative colitis (ASUC) is one emergency in pediatric gastroenterology.The disease is serious, which may even endanger the life of patients.Close monitoring and timely pharmacological and surgical interventions are key measures to improve outcomes.Treatment methods for ASUC include necessary nutritional support, water and electrolyte disturbance correction, and possible concurrent bacterial or viral infection elimination.Patients at high risk require subcutaneous injections of low molecular weight heparin to prevent thrombosis.Intravenous cortico-steroids are the first-line treatment of ASUC.For patients showing insufficient response to corticosteroids after 3-5 days, rescue treatment with immunosuppressants or biological agents is needed.Meanwhile, the clinical symptoms, serum inflammatory indicators and albumin levels of the patients should be closely monitored.Patients who failed medical treatment should undergo timely colectomy to prevent serious complications.In this paper, a systematic review of literature and expert consensus was conducted to summarize the clinical evaluation and treatment methods of ASUC children at different stages, in order to standardize the clinical treatment of pediatric ASUC.