- Bleeding that can’t be controlled.Severe bleeding from the colon may require surgery to remove the affected portion of the colon.
- Bowel obstruction.A blocked colon is an emergency that may require total or partial colectomy, depending on the site of the obstruction and any secondary damage due to distension of or loss of blood supply to the colon.
- Colon cancer.Early-stage cancers may require only a smaller section of the colon to be removed during colectomy. Multiple cancers, cancers presenting at a later stage and cancers presenting as an obstruction may require more of the colon to be removed.
- Crohn’s disease.If medications aren’t helping you, removing the affected part of your colon may offer temporary relief from signs and symptoms. Colectomy may also be an option if precancerous changes are found during a test to examine the colon (colonoscopy).
- Ulcerative colitis.Your doctor may recommend total colectomy if medications aren’t helping to control your signs and symptoms. Colectomy may also be an option if precancerous changes are found during a colonoscopy.
- Your doctor may recommend surgery to remove the affected portion of the colon if your diverticulitis recurs or if you experience complications of diverticulitis.
- Preventive surgery.If you have a very high risk of colon cancer due to the formation of multiple precancerous colon polyps, you may choose to undergo total colectomy to prevent cancer in the future. Colectomy may also be an option for people with inherited genetic conditions that increase colon cancer risk, such as familial adenomatous polyposis or Lynch syndrome.
In the elective situation, the type of surgery considered best for you and your clinical circumstances will be discussed, along with any options. It may obviously be a little more difficult to have this discussion at length in the emergency situation.