Postoperative complications of ulcerative colitis. Acute tubular necrosis and hypersensitivity to donor blood following colectomy.

Abstract

Introduction The treatment of chronic ulcerative colitis is primarily medical, with surgical treatment reserved for those patients with the complications of perforation, hemorrhage, carcinomatous degeneration, perirectal abscesses and fistulas, or intractable disease. Zetzel 1 has stated that most of the patients remain in a satisfactory state of health in spite of chronicity and recurrence and that only 10% to 15% require surgery. Many of the patients with extensive colitis come to the surgeon only after they have reached a state of emotional and physical exhaustion. The numerous postoperative complications have been extensively reported. 2,3 Two complications that have not been adequately emphasized are the development of sensitization to minor blood groups following multiple transfusions and the insidious occurrence of acute tubular necrosis accompanying surgery. The purpose of this paper is to describe the genesis of these complications and their management in a patient who had a onestage ileostomy and total