IBD

Question 1

Sever colitis

1. What criteria?

Answer 1

Truelove and witts:

1. > 6 blood BM/day
2. T > 37.5
3. HR > 90
4. Anemia <75% of normal
5. ERS >30

Question 2

Toxic colitis

1. What criteria?
2. What percentage need surgery

Answer 2

Truelove and witts:

1. > 10 blood BM/day
2. T > 37.5
3. HR > 90
4. Anemia needing transfusion
5. ERS >30
6. abdomen dissented + tender
7. imaging = colonic distension >6cm (toxic megacolon)

1/3 need surgery

Question 3

Once you perforate risk of death (contained or free)? What signs do you use?

Answer 3

30%

worsening peritonitis / distension / pneumatosis coli / multiorgan failure

Question 4

Medical responder - what percent will eventually need surgery

Answer 4

30%

thus get surgery + ostomy care involved in all early