Early surgery in the management of severe ulcerative colitis.

During the last two decades there has been a substantial improvement in the overall outlook for patients suffering from ulcerative colitis. Nevertheless, many patients continue to ex- perience severe attacks of this disease, and the mortality from these attacks is often very high. Thus Gallagher et al. (1962) stated that nearly two-thirds of their patients with "fulmin- ating" attacks of colitis during 1950-8 died; Edwards and Truelove (1963) reported a 26.8% fatality rate in all severe attacks treated during the previous decade; while Demole (1956) noted a 40% fatality rate in all acute attacks of colitis.