Toxic megacolon in ulcerative colitis: a continuing challenge.

The incidence, predisposing factors, management and outcome of toxic megacolon (TM) has been reviewed in 65 cases of severe ulcerative colitis (UC) and compared in 2 successive 6-year periods before and after January, 1973. Nineteen episodes of TM occurred in 18 patients. Despite a conscious aim towards earlier surgery in recent years this was not achieved, and despite more intensive medical therapy the incidence of TM was unchanged.

The use of topical thrombin to reduce wound haematoma in patients receiving low-dose heparin.

The efficacy of topical thrombin in prevention of wound haematoma in patients receiving subcutaneous low-dose heparin was studied in a randomized, controlled trial. One hundred and two patients undergoing elective abdominal surgery were included in the trial. Haematological studies were carried out in the last 42 patients to determine whether introduction of thrombin into the wound resulted in any systemic effect via the coagulation pathways.