[A case of ulcerative colitis relapsing at the defunctionalized colon after subtotal colectomy]

A 25-year-old female with left sided ulcerative colitis underwent subtotal colectomy, and colo-anal anastomosis with diverting ileostomy by combined abdomino-sacral approach on February 14, 1985. Immediately after the operation, bleeding from the anus occurred, and one month after the operation, endoscopic examination revealed the relapse of the ulcerative colitis in the remaining colon. It was recognized, that relapse had occurred postoperatively at the nonfunctioning colon, which had been free from the disease so long as eight years since the onset of the disease. Then the relapsed colon was removed, and ileoanal anastomosis with diverting ileostomy was performed, again by combined abdomino-sacral approach. The sacral approach offered an excellent operative field and ensured the anastomosis between the small intestine and the anus.