Secondary pouchitis in a post-operative patient with ulcerative colitis, successfully treated by salvage surgery.
We report a case of secondary pouchitis, defined as a mucosal inflammatory lesion in the ileal reservoir provoked by pouch-related complication following total colectomy and pouch anal anastomosis, which was successfully treated by salvage surgery. A 20-year-old woman with ulcerative colitis developed acute severe bloody diarrhea following proctocolectomy, ileal pouch-anal anastomosis and diverting ileostomy. She was diagnosed as having a secondary pouchitis mainly caused by a peripouch abscess and partly concerned with the abnormal pouch formation. The remnant rectum and ileal pouch were excised and ileal pouch-anal anastomosis and diverting ileostomy were constructed. The postoperative course was uneventful with no sign of pouchitis. Salvage surgery may be indicated to treat secondary pouchitis when caused by surgery-related complications.
Toiyama
Yuji
Y
The Second Department of Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
Araki
Toshimitsu
T
Yoshiyama
Shigeyuki
S
Miki
Chikao
C
Kusunoki
Masato
M
D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects; D002648:Child; D003093:Colitis, Ulcerative / Q000150:complications / Q000601:surgery; D039021:Colonic Pouches / Q000009:adverse effects / Q000473:pathology; D005260:Female; D006801:Humans; D019449:Pouchitis / Q000209:etiology / Q000601:surgery; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*