Subtotal Colectomy with Ileoproctostomy or Ileostomy and Sigmoid Mucous Fistula

Abstract

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.