Pouch polyposis after ileal pouch-anal anastomosis for familial adenomatous polyposis: report of a case.
OBJECTIVE
A case of a patient with familial adenomatous polyposis (FAP) is reported, in whom adenomas developed in an ileal pelvic pouch six years after it was made. This case is reported to serve as a warning that restorative proctocolectomy, a relatively recent addition to surgical options for FAP, does not remove the risk of metachronous intestinal neoplasia; it merely defers it.


METHODS
Case of a patient with pouch polyposis was reviewed, and patient was prospectively studied after three months of sulindac therapy.


RESULTS
Polyps not removed at first examination became much less prominent. Literature review reveals only one study of adenomas in pelvic pouches, with 7 cases of 38.


CONCLUSIONS
Proctocolectomy and ileal pouch-anal anastomosis does not cure FAP, and multiple polyps can occur in the ileal pouch.
Church
J M
JM
David G. Jagelman Center for Inherited Colorectal Cancer, Department of Colorectal Surgery, Cleveland Clinic Foundation, Ohio, USA.
Oakley
J R
JR
Wu
J S
JS
D000236:Adenoma / Q000628:therapy; D011125:Adenomatous Polyposis Coli / Q000601:surgery*; D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003113:Colonoscopy; D003131:Combined Modality Therapy; D006801:Humans; D007078:Ileal Neoplasms / Q000628:therapy; D008297:Male; D016609:Neoplasms, Second Primary / Q000628:therapy; D016737:Proctocolectomy, Restorative; D013467:Sulindac / Q000627:therapeutic use
D000894:Anti-Inflammatory Agents, Non-Steroidal; D013467:Sulindac