ILEITIS AFTER COLECTOMY FOR ULCERATIVE-COLITIS OR CARCINOMA

An ileitis developing years or months after ileostomy was recognised a nd described many years ago but has rarely been mentioned since. We de scribe nine patients with a non-specific preanastomotic ileitis that d eveloped years after colectomy in patients operated on for ulcerative colitis or carcinoma. The disease developed after various types of rec onstruction: ileorectal, ileoanal, with or without pouch. The diseased ileum showed inflammation, erosions, ulcerations, and sometimes stric tures. The disease course ranged from asymptomatic to severe pain and diarrhoea. No specific cause could be shown. Granulomas, infectious ag ents or ischaemic changes were not found. The anastomosis was always p atent. Three patients have had numerous episodes of intestinal obstruc tion presumably because of adhesions. Seven of nine patients were fema le. The response to steroids, 5-aminosalicyclic acid preparations, and methotrexate was poor, three patients responded well to azathioprine. The condition is not rare and the cause remains unknown.