Colitis and Pseudopolyposis

Abstract

This patient underwent urgent laparotomy (February 1989) for toxic megacolon that was initially interpreted as mechanical large bowel obstruction. The surgeon performed a loop colostomy in the transverse colon. The true nature of the disease was revealed with a subsequent colonoscopy, which demonstrated severe colitis from the rectosigmoid to the cecum. The patient made a satisfactory recovery and was referred for further management 6 months after the urgent operation. Colonoscopy revealed an active colitis commencing at the rectosigmoid, with extensive polyposis extending to the transverse colon. The colon proximal to the colostomy was diffusely inflamed without obvious ulceration or polypoid lesions. The mucosa of a large prolapsed transverse colostomy was relatively normal.