Post-colectomy enteritis with ulcerative colitis: a rare but severe inflammatory condition

Post-colectomy enteritis is a rare but potentially life-threatening complication of colectomy in patients with ulcerative colitis. The current evidence is limited to case reports and small retrospective case series, suggesting that this condition is likely underdiagnosed and often recognized only in advanced stages.

We performed a comprehensive bibliographic search in Medline (via PubMed) up to April 2025 to collect available data on its clinical presentation, management, and outcome.

Although its pathogenesis remains poorly understood, the disease typically presents with severe diarrhea, abdominal pain, and systemic inflammatory signs requiring prompt intervention. First-line therapy consists of high-dose intravenous corticosteroids, whereas biologic therapy may be needed in refractory or severe cases. Management remains largely empirical, and delayed diagnosis may contribute to increased morbidity and mortality. Implementing a structured diagnostic and therapeutic approach could improve early recognition and treatment, while further studies are required to clarify underlying mechanisms, optimize management strategies, and define the relationship between this condition and other forms of small bowel involvement in ulcerative colitis.

Raising awareness of post-colectomy enteritis among clinicians is crucial to prevent misdiagnosis and to reduce the burden of this rare but severe post-surgical complication.