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International Journal of Colorectal Disease

, Volume 10, Issue 4, pp 222–224 | Cite as

Colectomy for acute colitis: is it safe to close the rectal stump?

  • R. F. McKee
  • R. A. Keenan
  • A. Munro
Originals

Abstract

We report 62 operations for acute colonic inflammatory bowel disease in which the rectal stump was closed. Operative findings were of severe colitis in 46, toxic megacolon in 8 and faecal peritonitis in 8 patients. Histology showed ulcerative colitis in 48, Crohn's disease in 9 and indeterminate colitis in 5 patients. Clinical evidence of stump leakage occurred in only one of 53 patients with a long rectal stump in contrast to 3 of 9 patients who had a short rectal stump. Leaving a very short stump also led to difficulty at subsequent proctectomy in 3 patients and at restorative proctocolectomy in 1 patient. This suggests that careful closure of the rectum above the peritoneal reflection can be a safe means of dealing with the rectal stump after total colectomy and ileostomy for acute colitis.

Keywords

Colite Ulcerative Colitis Megacolon Restorative Proctocolectomy Rectal Stump 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Nous rapportons l'expérience de 62 résections coliques pour poussées inflammatoires aiguës du côlon chez lesquelles le moignon rectal a été fermé. Les constatations opératoires mettaient en évidence une colite sévère chez 46 patients, un mégacôlon toxique chez 8 patients et une péritonite fécale chez 8 patients. L'examen histologique a mis en évidence une colite ulcéreuse chez 48 patients, une maladie de Crohn chez 9, une colite indéterminée chez 5. Un lâchage clinique du moignon rectal ne s'est produit que chez un des 53 patients chez lesquels le moignon rectal était long comparativement à 3 sur 9 patients dont le moignon rectal était court. Un moignon rectal court a, par ailleurs, entraîné des difficultés opératoires lors d'une proctectomie subséquente chez 3 patients et d'une procto-colectomie avec rétablissement de la continuité chez 1 patient. Ces observations suggèrent qu'une fermeture soigneuse du rectum au-dessus de la ligne de réfection du péritoine peut être un moyen sûr de traiter le moignon rectal apprès colectomie totale et iléostomie en cas de colite aiguë.

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References

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Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • R. F. McKee
    • 1
    • 3
  • R. A. Keenan
    • 2
  • A. Munro
    • 1
  1. 1.Raigmore HospitalInvernessUK
  2. 2.Ward 50Aberdeen Royal InfirmaryAberdeenUK
  3. 3.Department of ColoproctologyRoyal InfirmaryGlasgowUK

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