Emergency abdominal colectomy with primary anastomosis

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Abstract
From 1968-1979, 18 patients underwent emergency abdominal colectomy with ileorectal anastomosis. Indications for operation included massive colonic bleeding (11), obstructing carcinoma (5), toxic megacolon (1) and enterocolitis (1). Five patients died postoperatively (27.8%). Causes of death included sepsis, upper gastrointestinal bleeding and respiratory failure. All had peritonitis and 5 had documented anastomotic leaks. Seven of the surviving patients had significant morbidity from the procedure which included anastomotic leak, small bowel obstruction, wound infection, sepsis and pulmonary emboli. Only 6 patients survived without complications. The safety of emergency subtotal colectomy with ileoretal anastomosis was discussed. This procedure is apparently associated with excessive morbidity and mortality.