Obstructing inflammatory fibroid polyp in pelvic ileal reservoir after restorative proctocolectomy in ulcerative colitis. Report of a case.
OBJECTIVE
This study was designed to describe clinical, endoscopic, and histopathologic features of an inflammatory fibroid polyp occurring in the pelvic ileal reservoir after restorative proctocolectomy in ulcerative colitis.


METHODS
A case report describing the clinical course of such a patient is presented.


RESULTS
Three years postoperatively, the patient developed diarrhea, anemia, weight loss of 10 kg, and symptoms of obstructed defecation. Ileoscopy showed pouchitis and a polypoid tumor filling the pouch. Biopsies revealed chronic inflammation without signs of malignancy. At laparotomy, a 5 cm x 3.5 cm x 3.5 cm submucosal, solid, circumscribed tumor was found within the pouch, and histopathologic examination yielded the diagnosis. The pelvic pouch was resected and replaced by a Brooke ileostomy. During 18 months of follow-up, the course has been uneventful.


CONCLUSIONS
Inflammatory fibroid polyp is a rare, reactive, non-neoplastic lesion, which, for the first time, is reported in a pelvic ileal reservoir. It may cause pouch dysfunction. It is always benign but may masquerade as a malignant tumor.
Tysk
C
C
Department of Medicine, Orebro Medical Center Hospital, Sweden.
Schnürer
L B
LB
Wickbom
G
G
D000328:Adult; D003093:Colitis, Ulcerative / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal; D005350:Fibroma / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007078:Ileal Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007081:Ileostomy; D007249:Inflammation / Q000175:diagnosis / Q000209:etiology; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007417:Intestinal Polyps / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008297:Male; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*; D012086:Reoperation