Article

Surgical Therapy for Diffuse Granulomatous Colitis

Authors: JESSE T. DAVIDSON, III, MD, JOHN L. SAWYERS, MD

Abstract

Of 16 patients with diffuse granulomatous colitis treated surgically, nine initially had total proctocolectomy and seven had abdominal colectomy with ileorectal anastomosis. There was no mortality in either group, and there was no anastomotic leak from ileorectal anastomosis. Disease recurred in 22% of patients after proctocolectomy and in 57% of patients with ileorectal anastomosis. A review of the literature on the surgical management of Crohns colitis reveals a recurrence rate of 3% to 46% (average 20%) after proctocolectomy and a recurrence rate of 6.6% to 75% (average 46%) after ileorectal anastomosis. Colectomy with ileorectal anastomosis is the operation of choice for Crohns colitis where feasible.

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