Pouch-sacral fistula three years after restorative proctocolectomy for ulcerative colitis.
Fistula formation after restorative proctocolectomy poses a challenge to the surgeon and sometimes can lead to the excision of the pouch. A 21-year-old female patient developed an ileal J-pouch-sacral fistula with abscess and osteomyelitis of the sacrum, more than three years after the pouch construction for ulcerative colitis. Two months prior to this event, the patient had a single and transient episode of pouchitis. The role of pouchitis in the aetiopathogenesis of the fistula is unclear. To our knowledge, the late development of such a fistula has not been reported previously.
Bursics
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A
Department of Abdominal Surgery, University Clinic Gasthuisberg, Catholic University of Leuven, Belgium.
Penninckx
F
F
Van Olmen
A
A
D'Hoore
A
A
Filez
L
L
D000038:Abscess / Q000209:etiology; D000328:Adult; D003093:Colitis, Ulcerative / Q000601:surgery; D005260:Female; D005402:Fistula / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology*; D010019:Osteomyelitis / Q000209:etiology; D019449:Pouchitis / Q000209:etiology; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*; D012447:Sacrum / Q000473:pathology*; D013122:Spinal Diseases / Q000209:etiology*