A 48-year-old man on ICU has acute severe colitis from ulcerative colitis. IV hydrocortisone for 5 days has failed. The Travis criteria predict 85% co...

Question

A 48-year-old man on ICU has acute severe colitis from ulcerative colitis. IV hydrocortisone for 5 days has failed. The Travis criteria predict 85% colectomy rate. What rescue therapies should be considered?

Accepted Answer

IV ciclosporin (2 mg/kg/day) or IV infliximab (5 mg/kg) as rescue medical therapy; if rescue therapy fails within 48-72 hours, emergency subtotal colectomy with end-ileostomy is indicated

Answer

Continue IV steroids for 14 more days

Answer

Switch to oral steroids

Answer

Start methotrexate

Answer

Colonoscopy under general anaesthesia

uk-fficm MCQ (SBA): Acute Severe UC - Rescue Therapy

A 48-year-old man on ICU has acute severe colitis from ulcerative colitis. IV hydrocortisone for 5 days has failed. The Travis criteria predict 85% colectomy rate. What rescue therapies should be considered?