Chapter 9. Fulminant Colitis

  1. Adam Brooks FRCS (Gen Surg), DMCC Consultant Senior Lecturer3,4,
  2. Bryan A. Cotton MD, MPH Associate Professor5,
  3. Lt Col Nigel Tai MS, FRCS (Gen Surg), RAMC Consultant Senior Lecturer4,6 and
  4. Col Peter F. Mahoney OBE, TD, MSc, FRCA, RAMC Defence Professor7
  1. Deborah Nicol1 and
  2. Richard L. Wolverson Consultant Colo-Rectal Surgeon2

Published Online: 10 MAR 2010

DOI: 10.1002/9781444315172.ch9

Emergency Surgery

Emergency Surgery

How to Cite

Nicol, D. and Wolverson, R. L. (2010) Fulminant Colitis, in Emergency Surgery (eds A. Brooks, B. A. Cotton, N. Tai and P. F. Mahoney), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444315172.ch9

Editor Information

  1. 3

    Major Trauma Pathway Lead, General Surgery Service Lead, Nottingham University Hospital NHS Trust, Nottingham, UK

  2. 4

    Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK

  3. 5

    Department of Surgery and the Center for Translational Injury Research, The University of Texas Health Science Center, Houston, Texas, USA

  4. 6

    Defence Medical Services, Trauma Clinical Academic Unit, Royal London Hospital, Whitechapel, London, UK

  5. 7

    RCDM Birmingham Research, Park Vincent Drive, Birmingham, UK

Author Information

  1. 1

    SpR General Surgery, West Midlands, Worcester, UK

  2. 2

    City Hospital Birmingham, Birmingham, UK

Publication History

  1. Published Online: 10 MAR 2010
  2. Published Print: 31 JAN 2010

ISBN Information

Print ISBN: 9781405170253

Online ISBN: 9781444315172



  • fulminant colitis;
  • ulcerative colitis (UC), disease of unknown aetiology - diffuse mucosal inflammation limited to large bowel;
  • erythrocyte sedimentation rate (ESR) or C- reactive protein (CRP);
  • plain abdominal X-ray (AXR) at admission;
  • endoscopic evaluation of rectum and sigmoid colon plus biopsy;
  • resuscitation and medical management;
  • non-steroidal anti-inflammatory drugs, opiates and antidiarrhoeal drugs;
  • patients requiring emergency colectomy for fulminant colitis;
  • procedure of choice in fulminant colitis - subtotal colectomy with end ileostomy and rectal stump


This chapter contains sections titled:

  • Introduction

  • Clinical presentation

  • Investigation

  • Management

  • Indications for surgery

  • Anaesthetic issues

  • Surgery

  • Further reading