Results of split-ileostomy in Crohn's disease of the colon

In a period of seven years split-ileostomies were performed in 30 patients with Crohn's disease of the colon. Patients with the previous resection of the bowel were excluded. The indications for the diverting-ileostomy were: 1 toxic colitis unresponsive to intensive conservative therapy, and 2 long standing colitis, with or without perianal fistulae, not adequately responding to conservative treatment. Regarding the results, a split-ileostomy would seem to be indicated in debilitated patients in whom a resection at the time of the primary laparotomy carries too great a risk. None of our nine patients died. In long-standing disease a split-ileostomy for the purpose of healing or limiting the ultimate resection is not satisfactory. In only four out of 21 electively performed ileostomies this goal was achieved. We have too little experience with split-ileostomies in the treatment of extensive perianal and rectovaginal fistulae.