title: Colectomy for acute colitis: is it safe to close the rectal stump?
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.
authors.affiliation: Raigmore Hospital, Inverness, UK.
authors.forename: R F
authors.initials: RF
authors.lastname: McKee
authors.forename: R A
authors.initials: RA
authors.lastname: Keenan
authors.forename: A
authors.initials: A
authors.lastname: Munro
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003082:Colectomy / Q000379:methods*; D003092:Colitis / Q000601:surgery*; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery; D012007:Rectum / Q000601:surgery*; D012086:Reoperation / Q000379:methods