Follow‐up Investigation of Children with Ulcerative Colitis With Special Reference to Indications for Surgical Therapy

作者：Rutger Lagercrantz · 发表于：Acta Paediatrica · 年份：1955 · DOI：10.1111/j.1651-2227.1955.tb04144.x · 被引用次数：39 · 研究领域：Inflammatory Bowel Disease、Microscopic Colitis、Intestinal Malrotation and Obstruction Disorders

Summary One hundred and thirty‐seven patients who fell ill with ulcerative colitis before fifteen years of age have been followed for two to twenty‐six years (Tables 2 and 3). Of these 78.8 % had the chronic intermittent type of disease. Nineteen patients died after varying periods (Table 2), seventeen (12.4%) of ulcerative colitis or its complications. Of those surviving 8.8 % were found to be severely incapacitated on follow‐up examinations. Those who had had symptoms for more than nine years seldom recovered (Table 2). Even patients who had been free from symptoms for several years ran the chance of developing cancer of the colon at an early age and in this series the total frequency was 4.4 %. Operations with modern techniques (combined ileostomy and colectomy) have been performed in five cases with good results (Table 4.) Broader indications for operation seem warranted and surgery is recommended for all severe cases which show incapacitating symptoms for several years without response to medical treatment. Operation should be considered even in moderately severe cases with symptoms for more than eight to nine years, because of the risk of colonic cancer. There is no proof in this material that early chemo‐ or antibiotic therapy can influence the long‐term prognosis (Table 5). These results correspond with the modern view of the etiology and pathogenesis of the disease. Ulcerative colitis is probably a “hypersensitive reaction” rather than a primary infection. Psychother...