OUTCOME OF SURGICAL MANAGEMENT IN EXTRA INTESTINAL MANIFESTATIONS OF ULCERATIVE COLITIS- A CASE REPORT

BackgroundExtra intestinal manifestations of inflammatory bowel disease are prevalent in ulcerative colitis. The most common manifestations involve the musculoskeletal and dermatologic systems. Other manifestations involve the hepatobiliary system as well as the ocular, renal, and pulmonary systems. A multidisciplinary team approach is often needed for effective management, and emergency situations require prompt evaluation.Case Report This is a case report of young male age of 30 years, presented with bleeding per rectum for three months. He passed loose stools mixed with blood and mucus. He had loss of weight and appetite for two weeks. He had pain in the lower abdomen which is dull ache in nature, not radiating, relieved by medications. His blood investigations were normal except ESR which was grossly elevated. During admission he developed skin lesion over left leg which was diagnosed as pyoderma gangrenosum. Colonoscopy showed Severe inflammatory bowel disease with Multiple pseudo-polyps present in upper rectum. Upper GI endoscopy was normal study up to D2. He underwent lap assisted total colectomy with end ileostomy. In third postoperative day his ESR values became normal. His skin lesions were healed by sixth postoperative day and discharged. Histo pathology report showed features of ulcerative colitis with pseudo polyp formation.Conclusion Surgical removal of affected colon in ulcerative colitis is an effective management for extra intestinal manifestations which showed rapid recovery following surgery.