Solitary J-pouch ulcer causing pouchitis-like syndrome.
A 37-year-old man with familial polyposis coli who had undergone restorative proctocolectomy with a J-pouch as an ileal reservoir developed a solitary mucosal ulcer in the reservoir, causing a pouchitis-like syndrome. There was no endoscopic evidence of further inflammatory changes of the mucosa. The ulcer healed and symptoms subsided after six weeks of therapy with metronidazole followed by tetracycline. Possible causal and pathogenic factors are considered and discussed. Association of this patient's lesion with the nonspecific mucosal inflammatory process described in pouchitis is suggested by similar clinical manifestations and outcome.
D000328:Adult; D003082:Colectomy / Q000009:adverse effects; D003111:Colonic Polyps / Q000150:complications / Q000601:surgery; D006801:Humans; D007079:Ileitis / Q000209:etiology* / Q000473:pathology; D007081:Ileostomy / Q000009:adverse effects*; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D013577:Syndrome; D014456:Ulcer / Q000209:etiology* / Q000473:pathology