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ACUTE FULMINATING ULCERATIVE COLITIS WITH MASSIVE PERFORATION AND PERITONITIS: Report of a Case

ACUTE FULMINATING ULCERATIVE COLITIS WITH MASSIVE PERFORATION AND PERITONITIS: Report of a Case Abstract THE RECENT opportunity to study in the ward and in the pathology laboratory a case of acute fulminating ulcerative colitis with massive perforation and peritonitis stimulated a review of the literature in this regard. Its rarity together with its urgent therapeutic demands prompts me to present the following study of a case with a review of the literature. REPORT OF A CASE T. H. was a 43 year old, white woman, a divorcee, who was brought to the hospital in a state of profound shock. Her chief complaint was diarrhea of four weeks' duration. Because of her persistently critical condition and the absence of relatives, the history obtained is lacking in detail and probably to some extent in accuracy.She was born in Oregon, had lived in the United States all her life and had come to Boston a few months previously. She had been married and divorced, was childless References 1. Arthur Tracy Cabot Fellow in the Laboratory for Surgical Research, Harvard Medical School. 2. Fluids administered were as follows: 10/20/43 Whole blood, 1,000 cc. given intravenously Plasma, 250 cc. given intravenously Plasma, 250 cc. given intrasternally 5 per cent dextrose in isotonic solution of sodium chloride, 2,000 cc. given intravenously 5 per cent dextrose in water, 1,000 cc. given intravenously 5 per cent dextrose in water, 1,000 cc. given by clysis Total....................................................... 5,500 cc. 10/21/43 5 per cent dextrose in isotonic solution of sodium chloride, 1,000 cc. given intravenously 5 per cent dextrose in isotonic solution of sodium chloride, 1,000 cc. given intrasternally 5 per cent dextrose in water, 1,000 cc. given intrasternally Total...................................................... 3,000 cc. 10/22/43 5 per cent dextrose in isotonic solution of sodium chloride, 1,000 cc. given intravenously 5 per cent dextrose in water, 1,000 cc. given intravenously Plasma, 250 cc. given intravenously Total....................................................... 2,250 cc. 10/23/43 Whole blood, 1,000 cc. given intravenously Plasma, 500 cc. given intravenously 5 per cent dextrose in water, 1,000 cc. given intravenously 5 per cent dextrose in isotonic solution of sodium chloride, 1,000 cc. given by clysis Total........................................................ 3,500 cc. 10/24/43 Plasma, 250 cc. given intravenously 5 per cent dextrose in isotonic solution of sodium chloride, 1,000 cc. given intravenously 5 per cent dextrose in water, 1,000 cc. given by clysis Total....................................................... 2,250 cc. 3. Brown, P. W.; Buie, L. A., and Weber, H. M.: An Unclassified Type of Ulcerative Disease of the Colon , South. M. J. 35:305, 1942.Crossref 4. Bargen, J. A.: The Modern Management of Colitis , Springfield, Ill., Charles C Thomas, Publisher, 1943, p. 322. 5. The Diplostreptococcus is more commonly referred to in this condition as Bargen's bacillus. 6. Schlicke, C. P., and Bargen, J. A.: Fulminating Ulcerative Colitis: A Critical Analysis of Twenty Cases , Minnesota Med. 23:348, 1940. 7. (a) Acute Ulcerative Colitis with Perforation, Cabot Case 19021 , New Eng. J. Med. 208:89, 1933Crossref 8. (b) Acute Idiopathic Colitis with Perforation of Transverse Colon, Cabot Case 23201 , New Eng. J. Med. 216:894, 1937Crossref 9. (c) Ulcerative Colitis with Perforation of Cecum, Cabot Case 24041 , New Eng. J. Med. 218:183, 1938Crossref 10. (d) Acute Idiopathic Ulceration Colitis with Perforation, Cabot Case 27242 , New Eng. J. Med. 224:1029, 1941.Crossref 11. Bunch, G. H.: Acute Phlegmonous and Non-Traumatic Perforative Lesions of the Colon: Report of Three Cases with Intraperitoneal Hemorrhage Complicating One , South. Surgeon 6:449, 1937. 12. Bargen, J. A.: The Management of Colitis, edited by M. Fishbein, National Medical Monograph , New York, National Medical Book Company, Inc., Double-day, Doran & Company, Inc., 1935, p. 233. 13. Mones, F. G., and Sanjuan, P. D.: Grave Ulcerative Colitis Without Amebic Etiology: Diagnosis with Lucid Treatment , Am. J. Digest. Dis. & Nutrition 4:247, 1937. 14. Schlicke, C. P., and Bargen, J. A.: "Clubbed Fingers" and Ulcerative Colitis , Am. J. Digest. Dis. 7:17, 1940. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

ACUTE FULMINATING ULCERATIVE COLITIS WITH MASSIVE PERFORATION AND PERITONITIS: Report of a Case

Archives of Surgery , Volume 53 (4) – Oct 1, 1946

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Publisher
American Medical Association
Copyright
Copyright © 1946 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1946.01230060470011
Publisher site
See Article on Publisher Site

Abstract

Abstract THE RECENT opportunity to study in the ward and in the pathology laboratory a case of acute fulminating ulcerative colitis with massive perforation and peritonitis stimulated a review of the literature in this regard. Its rarity together with its urgent therapeutic demands prompts me to present the following study of a case with a review of the literature. REPORT OF A CASE T. H. was a 43 year old, white woman, a divorcee, who was brought to the hospital in a state of profound shock. Her chief complaint was diarrhea of four weeks' duration. Because of her persistently critical condition and the absence of relatives, the history obtained is lacking in detail and probably to some extent in accuracy.She was born in Oregon, had lived in the United States all her life and had come to Boston a few months previously. She had been married and divorced, was childless References 1. Arthur Tracy Cabot Fellow in the Laboratory for Surgical Research, Harvard Medical School. 2. Fluids administered were as follows: 10/20/43 Whole blood, 1,000 cc. given intravenously Plasma, 250 cc. given intravenously Plasma, 250 cc. given intrasternally 5 per cent dextrose in isotonic solution of sodium chloride, 2,000 cc. given intravenously 5 per cent dextrose in water, 1,000 cc. given intravenously 5 per cent dextrose in water, 1,000 cc. given by clysis Total....................................................... 5,500 cc. 10/21/43 5 per cent dextrose in isotonic solution of sodium chloride, 1,000 cc. given intravenously 5 per cent dextrose in isotonic solution of sodium chloride, 1,000 cc. given intrasternally 5 per cent dextrose in water, 1,000 cc. given intrasternally Total...................................................... 3,000 cc. 10/22/43 5 per cent dextrose in isotonic solution of sodium chloride, 1,000 cc. given intravenously 5 per cent dextrose in water, 1,000 cc. given intravenously Plasma, 250 cc. given intravenously Total....................................................... 2,250 cc. 10/23/43 Whole blood, 1,000 cc. given intravenously Plasma, 500 cc. given intravenously 5 per cent dextrose in water, 1,000 cc. given intravenously 5 per cent dextrose in isotonic solution of sodium chloride, 1,000 cc. given by clysis Total........................................................ 3,500 cc. 10/24/43 Plasma, 250 cc. given intravenously 5 per cent dextrose in isotonic solution of sodium chloride, 1,000 cc. given intravenously 5 per cent dextrose in water, 1,000 cc. given by clysis Total....................................................... 2,250 cc. 3. Brown, P. W.; Buie, L. A., and Weber, H. M.: An Unclassified Type of Ulcerative Disease of the Colon , South. M. J. 35:305, 1942.Crossref 4. Bargen, J. A.: The Modern Management of Colitis , Springfield, Ill., Charles C Thomas, Publisher, 1943, p. 322. 5. The Diplostreptococcus is more commonly referred to in this condition as Bargen's bacillus. 6. Schlicke, C. P., and Bargen, J. A.: Fulminating Ulcerative Colitis: A Critical Analysis of Twenty Cases , Minnesota Med. 23:348, 1940. 7. (a) Acute Ulcerative Colitis with Perforation, Cabot Case 19021 , New Eng. J. Med. 208:89, 1933Crossref 8. (b) Acute Idiopathic Colitis with Perforation of Transverse Colon, Cabot Case 23201 , New Eng. J. Med. 216:894, 1937Crossref 9. (c) Ulcerative Colitis with Perforation of Cecum, Cabot Case 24041 , New Eng. J. Med. 218:183, 1938Crossref 10. (d) Acute Idiopathic Ulceration Colitis with Perforation, Cabot Case 27242 , New Eng. J. Med. 224:1029, 1941.Crossref 11. Bunch, G. H.: Acute Phlegmonous and Non-Traumatic Perforative Lesions of the Colon: Report of Three Cases with Intraperitoneal Hemorrhage Complicating One , South. Surgeon 6:449, 1937. 12. Bargen, J. A.: The Management of Colitis, edited by M. Fishbein, National Medical Monograph , New York, National Medical Book Company, Inc., Double-day, Doran & Company, Inc., 1935, p. 233. 13. Mones, F. G., and Sanjuan, P. D.: Grave Ulcerative Colitis Without Amebic Etiology: Diagnosis with Lucid Treatment , Am. J. Digest. Dis. & Nutrition 4:247, 1937. 14. Schlicke, C. P., and Bargen, J. A.: "Clubbed Fingers" and Ulcerative Colitis , Am. J. Digest. Dis. 7:17, 1940.

Journal

Archives of SurgeryAmerican Medical Association

Published: Oct 1, 1946

References