Diverting ileostomy in the surgical management of Crohn's disease of the colon

Diverting ileostomy has been performed in thirteen patients with Crohn's disease of the colon with or without ileal involvement. Immediate and persistent relief of symptoms has occurred in all patients in three to twenty-four months (mean sixteen months) without evidence of recurrence. Radiologic as well as histologic findings have shown a return towards normal. Three patients have undergone restoration of intestinal continuity after two years. A mild recurrence developed in one patient which was controlled by corticosteroids whereas the other two remain well after two and thirty-six months. The results of diverting ileostomy have been unsuccessful in cases of chronic ulcerative colitis, further serving to illuminate fundamental differences in addition to clinical and histologic differences between these two inflammatory conditions. Further experience with this mode of therapy is justified.