This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Inflammatory bowel disease, Subject name: Surgery
[{'content': 'Procedure of choice in ulcerative colitis with acute perforation is: \nSelect and explain. \nA. Defunctioning ileostomy, B. Closure of perforation, C. Proximal diversion colostomy, D. Total colectomy and ileostomy', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Ulcerative colitis: Mx: SxOC: Total Proctocolectomy + Ileal pouch anal anastomoses. Mc type of pouch - J-shaped pouch SxOC Elderly with high risk of leak - Ileostomy SxOC perforation - Total colectomy + Ileostomy', 'role': 'assistant'}]