Subtotal Colectomy with Ileoproctostomy or Ileostomy and Sigmoid Mucous Fistula


When choosing an emergency operative procedure for the patient with complications of inflammatory bowel disease (hemorrhage, perforation, toxic megacolon), consider both the immediate problem and the long-term result. Remember that sphinctersparing procedures are now available for most of these patients, even when the rectum is involved by disease. Whenever possible retain the rectosigmoid, as it allows restorative proctocolectomy (see Chapter 10) to be performed at a later date.


Subtotal Colectomy Restorative Proctocolectomy Ileorectal Anastomosis Toxic Megacolon Divert Loop Ileostomy 
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  2. Longo WE, Oakley JR, Lavery IC, Church MJ, Fazio VW. Outcome of ileorectal anastomosis for Crohn’s colitis. Dis Colon Rectum 1992;35:1066.CrossRefPubMedGoogle Scholar

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© Springer Science+Business Media, LLC 2006

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