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Surgery NEET 2018 026523ed

All of the following are true about ulcerative colitis except:

A
Steroid dependent cases needs surgery
B
The highest risk of UC requiring surgery in 1st year
C
20% end up in colectomy
D
Extra-intestinal problems of UC are managed medically
High-Yield Explanation
Extraintestinal manifestations of ulcerative colitis: Migratory polyahritis Sacroiliitis Ankylosing spondylitis Uveitis Skin lesions Primary Sclerosing Cholangitis (PSC) Peri cholangitis Indication for Sx in UC: 1. Severe refractory fulminating disease 2. Chronic disease with a. Anaemia b. Frequent stools c. Tenesmus (cramping rectal pain) 3. Steroid-dependent disease 4. Remission cannot be maintained 5. Neoplastic change 6. Extra intestinal manifestations - PSC 7. Severe haemorrhage or stenosis causing obstruction rarely Sx of choice: 1. Subtotal colectomy & ileostomy - Emergency (20%) 2. Proctocolectomy and permanent end ileostomy 3. Proctocolectomy with ileoanal pouch. 4. Subtotal colectomy and ileorectal anastomosis

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