Diversion colitis describes a colitis that develops following diversion of feces. It may occur because the mucosa is no longer exposed to a fatty acid or other component in the feces necessary to maintain a healthy mucosa.


Features of diversion colitis:

(1) history of diversion of the fecal stream, usually with a colostomy

(2) subsequent development of a colitis or proctitis months to years later

(2a) The process may include aphthous ulcerations and mucosal friability.

(2b) Histologic features may resemble inflammatory bowel disease, including the presence of crypt abscesses.

(3) resolution following restoration of fecal flow through the involved segment

(4) exclusion of other causes of colitis (Crohn's disease, ulcerative colitis, Clostridium difficile disease, etc.)


Complications in severe diversion colitis:

(1) bowel wall perforation

(2) pneumatosis intestinalis

(2) sepsis


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