MANAGEMENT OF THE RECTUM FOLLOWING COLECTOMY FOR ACUTE COLITIS

During a 6 year period, 31 consecutive patients under the care of one surgeon had emergency colectomies for complicated colitis. A selective policy of closing the rectum intraperitoneally to minimize the length of retained diseased bowel and to avoid a mucus fistula was used duri ng the study period. One patient underwent proctocolectomy, 7 subtotal colectomy with mucus fistula and 23 total colectomies with intraperit oneal closure of the rectum. Two patients (8.9%) developed pelvic seps is. Both had intraperitoneal closure of the rectal stump and were read ily managed by drainage into the stump. Subsequent surgery in the 18 p atients having rectal excision has been uncomplicated. Intraperitoneal closure of the rectal stump in emergency surgery for complicated coli tis can be performed safely in most of these patients.