DOI: 10.36347/SASJM.2019.v05i11.001

Pages: 182-186

Acute severe ulcerative colitis is a serious complication of inflammatory bowel diseases. Its diagnosis is based on clinical and biological criteria. It’s management must be quick and multidisciplinary. This work is a retrospective study about 92 cases of acute severe ulcerative colitis collected during a period of 5 years in hepato gastroenterology department of the Mohammed VI University Hospital in Marrakech. The aim of our study is to describe the management of acute severe ulcerative colitis in our context. Acute severe ulcerative colitis accounted for 17% of cases of inflammatory bowel disease. Average age was 28.95 years with a peak of frequency between 21 and 30 years. A slight female predominance was observed (52%). Severe flare was inaugural in 60.8% of cases, the average time for consultation was 22 days. Truelove and Witts criteria were adopted for definition and admission of patients. Endoscopic evaluation showed severity signs in 24% of patients. Intravenous corticosteroid was the first-line therapy in 91 patients (98,9%). Response rate in corticosteroid therapy was 73,6%. Twenty-one patients required oral Ciclosporin as second-line treatment, and 3 patients required Infliximab. Almost half of our patients received an immunosuppressant as a maintenance therapy. Surgery was indicated in 16 cases (17%) including 4 cases who underwent emergency surgery for complications. The overall remission rate of the acute episode was 83% under intensive medical treatment, and 48 % six months after starting maintenance therapy. Mortality rate was 2,2%.