Surgical management of ulcerative colitis may be performed to treat which of the following complications?
A. Gastritis
B. Bowel herniation
C. Bowel outpouching
D. Bowel perforation
Correct Answer: D. Bowel perforation
Perforation, obstruction, hemorrhage, and toxic megacolon are common complications of ulcerative colitis that may require surgery. Perforation can also present in severe ulcerative colitis even in the absence of toxic megacolon. Most perforations occur in the left colon, commonly in the sigmoid colon. Perforations tend to occur more often during the first episodes of colitis.
Option A: Gastritis isn’t associated with irritable bowel diseases. The current classification of gastritis is based on time course (acute versus chronic), histological features, anatomic distribution, and underlying pathological mechanisms. Acute gastritis will evolve to chronic, if not treated. Helicobacter pylori (H. pylori) is the most common cause of gastritis worldwide.
Option B: Inguinal hernias are considered to have both a congenital and acquired component. Most adult hernias are considered acquired. However, there is evidence to suggest genetics also play a role. Patients with a known family history of a hernia are at least 4 times more likely to have an inguinal hernia than patients with no known family history.
Option C: Outpouching of the bowel is diverticulosis. Diverticulosis is a clinical condition in which multiple sac-like protrusions (diverticula) develop along the gastrointestinal tract. Though diverticula may form at weak points in the walls of either the small or large intestines, the majority occur in the large intestine (most commonly the sigmoid colon).
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