Transcaecal ileal diversion in the management of the 'at risk' distal colonic anastomosis.

Transcaecal ileal diversion has been used in association with primary resection and anastomosis to defunction an elective distal colonic anastomosis in 10 patients and to allow on-table colonic lavage with subsequent colonic defunction in 11 patients presenting as an emergency with distal colonic obstruction. Post-operative wound sepsis occurred in four patients (19%) with a clinical anastomotic leak in one patient. The median hospital stay was 14 (10-19) days. Transcaecal ileal diversion is simple to perform. It may facilitate primary resection and anastomosis in both the elective and emergency situation without increasing morbidity, mortality or the hospital stay.