UEG's educational platform for gastroenterology education bringing recordings, courses, guidelines, and more together in one place.

UEG Week Berlin 2025 Recordings Gut Guide online

Rate for better recommendations!

Your feedback helps us show you more of what you like and less of what you dislike!

More of this!

We will show you more similar content.

Not for me!

We won't suggest this again.

Bookmark!

Save this content for later!

New to myUEG? Create an account! Log In with myUEG account

UEG Poster

Standard Poster

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Free for all myUEG account holders. Your access level is set automatically based on your occupation. Medical professionals get full access to all content. If you are a non-medical user, you can only access UEG Week content from congresses you attended.

Not sure what you can access? Learn more about account types.

Introduction

Severe acute ulcerative colitis (ASUC) is a life-threatening medical emergency of colonic inflammatory bowel disease (IBD), most often in ulcerative colitis (UC) but also in Crohn's disease (CD).

Aims & Methods

The aim of our study was to compare the epidemioclinical and evolutionary profiles of ASUC in UC and in CD.
We conducted a retrospective, descriptive and comparative study including patients who presented with ASUC over a 10-year period [January 2010 - December 2019]. The diagnosis of ASUC was established on Truelove and Witts criteria and supported by endoscopic findings. Group 1 included patients with UC and group 2 included patients with CD. Patients followed for CD with anoperineal manifestations or upper gastrointestinal tract involvement were excluded. Data were entered and analyzed by SPSS software version 26.

Results

We included 71 patients with a sex ratio M/F of 0.65. The mean age at diagnosis of IBD was 31.08 years with extremes ranging from 12 to 58 years. Twenty-one percent of the patients had a body mass index greater than 25kg/m2. Thirty-three patients had UC, while 38 patients had CD. Patients in group 2 had a significantly lower mean age of occurrence of ASUC (30.84 vs. 37.33 years; p=0.02). The two groups were comparable for sex(p=0.62), smoking (p=0.71) and family history of IBD (p=0.94). ASUC was inaugural in 36.6% of the patients with no difference between the 2 groups (p=0.3). Twenty-six patients in group 1 were previously on treatment (p=0.03), mainly with Pentasa. For the diagnosis of ASUC, the median number of bloody stools was 7 with no difference between the 2 groups (p=0.56). The mean CRP level was significantly higher in group 2 (121mg/l vs 74.49mg/l;p=0.004). Severity signs on endoscopy were similar between the 2 groups (p=0.17). There was also no difference in the presence of colonic infection between the 2 groups (p=0.66). The response to the first line treatment with corticosteroids was found in 61.2% (n=38) and was significantly higher in group 2 (p=0.02). The mean number of bloody stools was significantly lower in group 2 at day 3 and day 5 of the treatment (p=0.003 and p=0.005 respectively). The decrease in mean CRP level at day 3 and day 5 of the treatment was comparable between the 2 groups (p=0.15 and p=0.12 respectively). Thus, the use of second-line therapy was more important in group 1 (p=0.017). There was no difference between the 2 groups regarding the occurrence of complications during the course of the disease, mainly colectasia, perforation and digestive bleeding (p=1, p=0.13 and p=1 respectively). Surgical treatment was required in 26.7% of the patients (n=19) without a difference between the 2 groups (p=0.53). It was significantly associated with an early occurrence of the ASUC (p=0.009), the need for second-line treatment (p<0.001) and the number of bloody stools at day 3 and day 5 of the follow-up (p<0.001 and p<0.001 respectively). There was no difference between the 2 groups regarding the occurrence of postoperative complications, mainly abscess (p=1) and rectal stump inflammation (p=0.6). The occurrence of a second ASUC under maintenance treatment was more important in group 1 without a significant difference (37.5 vs 14.7% p=0,08).

Conclusion

ASUC is the most severe complication of colonic IBD and is prone to an overall outcome independent of the type of the underlying IBD.

Disclosure

No conflict of interest

ACUTE SEVERE ULCERATIVE COLITIS: ULCERATIVE COLITIS VERSUS CROHN’S DISEASE

Wafa Khemiri 1, BEN MUTAPHA EP BEN ZID Nadia 1, Nour Ben Safta 1, Sarra Laabidi 1, Meriem Serghini Ep Ghachem 1, Monia Fekih 1, Asma Labidi 1, Jalel Boubaker 1

1 La Rabta Hospital , El Manar Faculty, Tunis, Tunisia

Conference

UEG Week Copenhagen 2023

Topics

IBD

Submission format

Abstract

Session

PP 05 IBD (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

UEG Mistakes In Articles

New

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Not sure what you can access? Learn more about account types.

Pancreatic exocrine insufficiency (PEI) is a common yet frequently under-recognised cause of maldigestion, malabsorption, and malnutrition. Although traditionally associated with primary pancreatic disorders such as chronic pancreatitis, cystic fibrosis, pancreatic cancer, or pancreatic surgery, it is now evident that PEI also occurs in a wide range of extra-pancreatic conditions and clinical settings. Advances in diagnostic testing and expanding clinical awareness have improved detection; however, significant misconceptions persist regarding when to suspect PEI; how to interpret diagnostic tests; and how to initiate, optimise, and monitor pancreatic enzyme replacement therapy (PERT). In everyday practice, these errors may lead to delayed diagnosis, inappropriate treatment, persistent symptoms, and preventable nutritional deficiencies. This “Mistakes in…” article highlights common pitfalls in the diagnosis and management of PEI, focusing on inappropriate reliance on faecal elastase testing, failure to recognise secondary causes, undertreatment with PERT, and inadequate nutritional assessment. By addressing these frequent mistakes, we aim to promote a more structured, patient-centred, and evidence-informed approach to PEI that improves clinical outcomes and quality of life.

Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Miroslav Vujasinovic, J. Enrique Domínguez Muñoz, Matthias Löhr

Topics

Pancreas

Published

2026

UEG Mistakes In Articles

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Not sure what you can access? Learn more about account types.

Crohn’s disease (CD) is a chronic inflammatory bowel condition that can present with a wide range of intestinal and extra-intestinal manifestations. This condition can develop at any age and have a significant impact and impairment on quality of life for individuals including on relationships, educational attainment and work productivity. In particular, the time around and after diagnosis often involves the most upheaval for patients, and equally the biggest opportunity for effective intervention. Several recent advances have had a major impact on optimal management of patients with newly diagnosed CD. Here, we discuss the mistakes that are commonly made when managing patients presenting with a new diagnosis of CD. We summarise the evidence base and offer helpful and pragmatic tips for practising clinicians.