Surgical Aspects in Management of Inflammatory Bowel Disease

Tetsuichiro Muto

Department of Surgery, University of Tokyo

Surgical aspects in management of inflammatory bowel disease (IBD) were reviewed with special emphasis on ulcerative colitis (UC). In a severe attack of UC a delay in surgical intervention may cost the patient's life. In chronic intractable cases a delay in surgery may affect the patient's quality of life. The modern technique of a pouch-operation avoiding ileostomy has made the decision of surgery much easier for both patients and physicians. Surveilance for dysplasia and cancer in long-standing colitis is mandatory. In Crohn's disease only minimal surgery for relieving complications with supplementary nutritional therapy is recommended. Anal fistula irrelevant to Crohn's disease itself can be treated as the usual fashion, laying it open. As rare conditions, clinicopathological features and management of solitary ulcer syndrome of the rectum and acute hemorrhagic ulcer of the rectum were described. It is important to understand the classification of IBD and the clinicopathological features of each disease for the correct management of IBD.

Key words
inflammatory bowel disease, ulcerative cslitis, dysplasia in ulcerative colitis

Reprint requests
Tetsuichro Muto Department of Surgery, University of Tokyo
7-3-1 Hongo, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
May 13, 1992

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