Multiple Rectal Ulcers (51 of 110)

Emergency surgery involves total colectomy and end
ileostomy as a life-saving procedure. Patients presenting
with severe acute colitis for their first attack are the most
likely to require colectomy (up to 25%) Following recovery
from a total colectomy, thought must be given to the fate
of the remaining rectum as it can continue to cause bloody
anal discharge if the inflammation fails to subside and it
remains a site of potential cancer, although the risk is
about 5% over 20 years. There are four options for the
residual rectum:

Elective

In the elective situation there are three surgical options:
1. Panproctocolectomy and end ileostomy
2. Total colectomy and ileorectal anastomosis
3. Panproctocolectomy and ileal pouch–anal anastomosis

The choice of operation depends on patient fitness,
sphincter function and choice. All three elective procedures
can now be carried out with laparoscopic assistance.