When is colectomy indicated in the treatment of inflammatory bowel disease (IBD)?

Updated: Oct 17, 2017
  • Author: William A Rowe, MD; Chief Editor: BS Anand, MD  more...
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Answer

Consider surgical intervention for patients in whom medical therapy fails, as it is curative for colonic disease, and for those with colonic dysplasia or malignancy. [3] Approximately 25%-30% of patients may require operative management. [1] The indications for colectomy are the following:

  • Intractable inflammation

  • Precancerous changes (high-grade dysplasia or proven multicentric, low-grade dysplasia confirmed by 2 expert pathologists)

  • Intolerance to medical therapy

  • Toxic megacolon

  • Perforation


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