Video Tip: Diagnosing Diversion Colitis | December 2022-Diagnosing Diversion Colitis

Video Transcription

This ASG video tip is brought to you by an educational grant from Braintree, a part of Cibela Pharmaceuticals, makers of SUTAB.  These changes are in the distal colon of a 70 year old man who six months ago presented with obstruction at the splenic flexure from a cancer.  He was operated with resection of the cancer, creation of a diverting colostomy and performance of the Hartman procedure.  These changes are seen in the distal colon during a colonoscopy, which is pre-op takedown of the colostomy.  No history of radiation here and these changes extended from the rectum all the way up to the closure of the Hartman pouch so too extensive for radiation colitis, not typical of UC because not circumferential and no history of prior bowel problems.  So this is early diversion colitis with time these changes of course can become much worse with friability, fissuring, narrowing of the bowel.  All these changes are reversible with takedown of the colostomy and resumption of the fecal stream through this bowel.

Video Summary

This video tip, sponsored by an educational grant from Braintree, explains the changes observed in the distal colon of a 70-year-old man who had undergone surgery for cancer six months ago. The video shows the colonoscopy conducted as part of the pre-operative takedown of the colostomy. The changes seen extend from the rectum to the closure of the Hartman pouch, indicating diversion colitis rather than radiation colitis or ulcerative colitis. These early changes can worsen over time, leading to friability, fissuring, and narrowing of the bowel. However, these changes are reversible upon resuming the fecal stream through the bowel after the colostomy is taken down.

Keywords

distal colon

diversion colitis

colostomy

radiation colitis

ulcerative colitis