Turnbull-Blowhole colostomy for toxic ulcerative colitis in pregnancy: report of two cases.
OBJECTIVE
Surgical intervention for toxic ulcerative colitis in pregnancy is associated with a high morbidity and mortality for both mother and her fetus. A limited surgical procedure may be desirable to reduce the risk of maternal and fetal mortality. We describe the use of "blowhole" colostomy and loop ileostomy (Turnbull procedure) in the management of toxic dilation of the colon complicating ulcerative colitis in pregnancy.


METHODS
The medical records of two pregnant females with toxic ulcerative colitis were reviewed. The presentations, management, and outcomes of these patients and their neonates are described.


RESULTS
The Turnbull-Blowhole colostomy and ileostomy was used in the acute management of toxic ulcerative colitis in two pregnant females. Both mothers and neonates had successful outcomes with resolution of the acute process. Completion proctocolectomy and ileal pouch-anal anastomosis was later performed in both patients.


CONCLUSIONS
The colonic decompression and fecal diversion procedure provided minimal operative trauma to the mother and fetus and resulted in successful outcome in the management of toxic ulcerative colitis in pregnancy. We believe the procedure is safe, effective, and relatively simple, which may reduce the morbidity and mortality of toxic colitis in pregnancy.
Ooi
Boon Swee
BS
Department of Colorectal Surgery, The Cleveland Clinic Foundation, Ohio 44195, USA.
Remzi
Feza H
FH
Fazio
Victor W
VW
D000328:Adult; D000714:Anastomosis, Surgical; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches; D003125:Colostomy / Q000379:methods*; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008532:Megacolon, Toxic / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D011256:Pregnancy Outcome