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May 1973

Physiological Colostomy

Arch Surg. 1973;106(5):741. doi:10.1001/archsurg.1973.01350170101031

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To the Editor.—The elemental diet, now finding widespread clinical use, was developed to reduce fecal volume from astronauts ("space diet") on prolonged voyages. A diverting colostomy is used to reduce exposure of an area of reconstruction or inflammation or both to the fecal stream. We successfully treated a patient with refractory diverticulitis with use of an elemental diet over the course of a month, a "physiological colostomy," as an alternative to surgery.

Report of a Case  A 54-year-old white man was seen with a four-week history of crampy pain in the lower part of the abdomen. This was associated with blood- and mucous-tinged diarrhea. There was no weight loss. He was allergic to tetracyclines.The patient had diffuse lower abdominal tenderness, maximum on the left, without evidence of peritonitis or intra-abdominal masses. He had a mild temperature elevation, 37.3 C (oral). His hemogram showed a similar inflammatory response, with

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