CLINICAL PROFILE OF PATIENTS WITH ACUTE SEVERE ULCERATIVE COLITIS IN NORTH INDIA
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Keywords
UC (Ulcerative colitis), ASUC (Acute Severe Ulcerative Colitis), ruelove & Witts diagnostic criteria, thrombocytosis
Abstract
Background: Ulcerative colitis (UC) is an idiopathic inflammatory disease predominantly involving colo-rectum. About 1/5th of UC patients presents in the form of acute severe ulcerative colitis (ASUC) which carries a significant morbidity and mortality. It is diagnosed on the basis of Truelove and Witts criteria.
Materials and Methods: A total of 30 consecutive patients diagnosed to have ASUC according to Truelove & Witts criteria were enrolled in study. Their clinical and laboratory parameters were determined which included CBC, RFT, LFT, ESR, CRP – quantitative, albumin and stool for clostridium difficle. Study duration was 15 months, from November 2022 to January 2024.
Results: Mean age of the patients was 38.83 ± 13.35 years. 19/30 (63.3%) were males and 11/30 (36.6%) were females. Among the 30 total patients, 20 (66.6%) had preexisting ulcerative colitis and 10 (33.3%) had new onset disease with first presentation as ASUC. Most common cause of flare was poor compliance to medical treatment (n=17/20; 85%) followed by NSAID use (n=2/20; 10%) and supra added clostridium difficle infection (n=1/20; 5%). When Truelove & Witts criteria was applied, along with >6 bowel movements with visible blood most common additional feature was raised ESR (> 30 mm/hour), seen in 24 (80%) patients. It was followed by tachycardia (pulse rate >90/minute), seen in 20 (66.6%) patients. Anaemia i.e. hemoglobin < 10.5 g% was present in 16 (53.3%) patients and fever (> 100.04°F) was present in 8 (26.6%) patients.
Most common clinical features were pain abdomen (n=25; 83.3%), followed by stool urgency (n=18; 60%) and tenesmus (n=7; 23.3%). Thrombocytosis was seen in (n=4; 13.3%) patients and hypoalbuminemia was seen in (n=11; 36.6%) patients.
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Dr Aakash Aggarwal
Associate Professor Department of General Surgery, MMIMSR, Mullana,
Dr Vivek Ahuja
Associate Professor, Department of Gastroenterology MMIMSR, Mullana.
Dr Gaurav Singal
Associate Professor Department of General Surgery, MMIMSR, Mullana,
Dr Prateek Sharda
Associate Professor Department of General Surgery, MMIMSR, Mullana.
Dr Madhur Sharma
Senior Resident, Department of Gastroenterology, MMIMSR, Mullana.