Inflammatory disease of the lower gastrointestinal tract in children

Ulcerative colitis and transmural colitis present with many of the same symptoms, but there is a differing frequency in the symptom complex. Early operation is preferable in transmural colitis and limited resection is usually helpful at first. Total colectomy is usually performed in patients with chronic ulcerative colitis, but only after a prolonged trial of nonoperative therapy. The histopathologic appearance of the two entities is different in most patients, and a clear delineation can be made by the pathologist. The evaluation of the patient preoperatively, technical aspects of the procedure, and the care in the postoperative period are described. Long-term prognosis for granulomatous colitis is not as good as that for ulcerative colitis [15]. However, both diseases are amenable to surgical therapy. Limited aggressive therapy is necessary in both entities. Earlier procedures are warranted for transmural colitis, and ultimately total colectomy is needed in patients with ulcerative colitis.