Dr Ed Wallitt
Podmedics - Founder
Video Duration: 8 minutes
Middle age with slight female proponderance.
Smoking is PROTECTIVE and 20% will require surgery and some time.
Unknown. Note that smoking is protective.
General: malaise anorexia and weight loss
Thin patient. May have erythema nodosum or pyoderma gangrenosum. Clubbing. Stoma bad
Distended and tender abdomen
Blood cultures (if fever), stool cultures (infection)
FBC, LFTs, CRP
Abdominal radiograph - megacolon (>6cm),
Chest radiograph - air under diaphragm (perforation)
Gastrograffin enema - lead piping and loss of haustra
Score with the Truelove and Witts Criteria
If acute colitis - fluid resuscitation and maintenance
Acute severe colitis - hydrocortisone IV + thromboprophylaxis
Inducting remission - 5-ASA, suppositories and enemas/foams for proximal disease
Maintenance - 5-ASAs. Azathioprine for those who relapse.
Associated surgical emergencies are:
20% will require surgery (resections)