Problems Resulting in Surgery (for CC)-SD

So, here's a list of some indication for the people who have the colectomy or removal of the colon surgically. So we know that um there's advance in the medical therapy but as-, it is estimated that 20% of the patients will eventually lose the colon due to the bad Ulcerative Colitis and some of the patients that develop Ulcerative Colitis have a side effect of to the medicine These are the patients who have the steroid side affect. And these the patients called Mega Colon, the colon is so dilated. And these are the patient where the colon wall is so thin. Like a paper thin and at the time of the surgery its so thin it almost perforates. "So thin it- oh, O.K." Uh, perforate. And some of the patient with hidden perforation here on the cat scan you can see the air along the bowel wall. So that-, you can push the medicine very far that a steroid and a biologic agent, sometimes those medicines may overlap-, may-, what you call over-, called uh mask the symptoms if you're not so bad but then hidden perforation already there. Another condition called Dysplasia. Dysplasia is a pre cancerous condition that happen in patients with Ulcerative Colitis or Crohn's Colitis for long duration. Look at the cells here. Here the cell and here the cell are different. Those cells here it is called dysplastic. That means it as bigger nuclei and as compare with cytoplasm. So the big nuclei it more tends to develop the cancer or even advance the cancer. And under the colonoscopy/endoscopy you can see the nodular, these bumps and lumps here. And its what we call a dysplastic lesion. So patients with dysplastic or pre cancerous lesions in the setting of Ulcerative Colitis and typically we would recommend the patient have colectomy.