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Updated: May 10, 2026
08:49
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Diversion colitis and involution of the defunctioned anorectum
A M Roe1, B F Warren, A J Brodribb
1Department of Surgery, Derriford Hospital, Plymouth.
Gut
|March 1, 1993
Summary
Defunctioning the rectum after Hartmann operation leads to diversion colitis, characterized by decreased rectal volume and chronic inflammation. These changes, evident by 3 months, indicate rectal stump involution.
Area of Science:
- Colorectal Surgery
- Gastroenterology
- Surgical Pathology
Background:
- The Hartmann operation is frequently performed for complications of diverticular disease and sigmoid carcinoma.
- Rectal defunction can lead to physiological and pathological changes in the rectal stump.
Purpose of the Study:
- To evaluate the effects of rectal defunction on anorectal physiology and pathology.
- To assess the development and characteristics of diversion colitis following the Hartmann operation.
Main Methods:
- Physiological studies (proctometrogram) and endoscopic assessment with mucosal biopsy were performed at 1 and 3 months post-Hartmann operation in 12 patients.
- Anal sphincter function, rectal volume, sensation, and compliance were measured.
- Endoscopic and histological features of diversion colitis were analyzed.
Main Results:
- No significant changes in anal sphincter function, rectal sensation, or compliance were observed.
- Rectal volume significantly decreased by 35% at 3 months compared to 1 month (p < 0.01).
- Endoscopy revealed erythema and granularity, while histology showed chronic inflammation, erosions, and lymphoid hyperplasia, consistent with mild diversion colitis.
Conclusions:
- Rectal defunction after Hartmann operation results in diversion colitis, characterized by reduced rectal volume and specific histological changes.
- These changes indicate progressive rectal stump involution and are distinct from inflammatory bowel disease.
- Early assessment at 3 months reveals mild but characteristic features of diversion colitis.
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