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.