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February 1960

Postoperative Complications of Ulcerative ColitisAcute Tubular Necrosis and Hypersensitivity to Donor Blood Following Colectomy

Author Affiliations

From the Department of Surgery, Maimonides Hospital of Brooklyn and the State University of New York Downstate Medical Center.; Director of Surgical Services, Maimonides Hospital of Brooklyn, and Professor of Surgery, State University of New York Downstate Medical Center (Dr. Hurwitz). Formerly Resident in Surgery, Maimonides Hospital of Brooklyn, and Assistant in Surgery, State University of New York Downstate Medical Center (Dr. Grossman).

AMA Arch Surg. 1960;80(2):262-266. doi:10.1001/archsurg.1960.01290190082016

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. Zetzel1 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

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