Inability to Reverse Colostomy Due to Poor/Friable Rectal Tissue

The case, as described, is somewhat unusual. Active, perforating diverticulitis is very uncommon in a 31 year old woman. Her associated conditions complicate her course, but are not causative. The percentage of diverticulitis cases at age 31 is well under 5%. Also, the operation, as described, a Hartmann procedure with end colostomy, usually treats the condition very well. As stated, her rectal tissue remains “poor/friable’. and this is unusually the case. With the bowel diverted, the inflammation in the pelvis usually subsides and the patient’s condition should improve, not deteriorate. Hypertension and diabetes become easier, not more difficult to stabilize. It is speculation, of course, but, I wonder if this patient has a disease other than diverticulitis. Crohn’s disease would more likely have this course. Ulcerative colitis could, but Crohn’s disease is more likely. I would like to review the pathology report as well.