[Colostomy as a cause of deviation colitis in a blind-ended bowel segment].
Two women aged 63 and 53 who had undergone colostomy for faecal incontinence, presented a few months later complaining of anal blood and mucous loss. On sigmoidoscopy, a previously healthy section of colorectum seemed to be inflamed. Local treatment with hydrocortisone and mesalazine and oral prednisolone did not relieve the symptoms. Subsequently the affected part of the colon was resected upon which the anal blood and mucous loss stopped. After a deviating stoma procedure, the colonic segment diverted from the faecal stream can develop signs of non-specific inflammation. The risk of colitis following the creation of a stoma is 0-50%. On systematic endoscopy 3-36 months following deviation, the risk of findings corresponding to deviation colitis is 50-100%. Symptoms are usually mild but can be so devastating that continuity of the faecal stream has to be restored or further resection is warranted.
Leids Universitair Medisch Centrum, afd. Chirurgie, Postbus 9600, 2300 RC Leiden. h.w.nijhof@lumc.nl
H W
HW
Nijhof
A T P M
AT
Claassen
J B V M
JB
Delemarre
D003092:Colitis / Q000209:etiology*; D003125:Colostomy / Q000009:adverse effects*; D005242:Fecal Incontinence / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors