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A prospective evaluation of diversion colitis.
1Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.
The American Surgeon
|January 1, 1991
Summary
Diversion colitis is a common condition affecting 70% of patients with a diverting colostomy, often without symptoms. This subclinical inflammation of the colon requires further investigation.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Diversion colitis, characterized by nonspecific colitis, is frequently reported in patients with fecal stream diversion.
- Published data on the actual frequency of diversion colitis and its etiologic factors are limited.
Purpose of the Study:
- To determine the frequency of diversion colitis in patients undergoing colostomy closure.
- To identify potential etiologic factors associated with diversion colitis.
Main Methods:
- Colonoscopy was performed on 20 patients scheduled for colostomy closure to evaluate the excluded colonic segment.
- Patients with ulcerative colitis or Crohn's disease were excluded from the study.
- Colonic findings were grossly classified as normal or colitis, with biopsies taken for microscopic examination.
Main Results:
- Diversion colitis was identified in 14 out of 20 patients (70%), while 6 patients had a normal examination.
- All nine biopsies from the diversion colitis group revealed microscopic abnormalities.
- No significant differences were observed in age, interval from colostomy formation, colostomy type, or reason for colostomy between the groups.
Conclusions:
- Diversion colitis is a prevalent subclinical condition in patients with diverting colostomies.
- The study highlights the high incidence of this condition, often presenting without overt symptoms.