Idiopathic small-intestinal inflammation after colectomy for ulcerative colitis.
OBJECTIVE
Severe ileostomy dysfunction with high ileostomy volumes or severe diarrhea after panproctocolectomy and restorative ileo-anal pouch formation are a rare but serious development after surgery for ulcerative colitis (UC). The incidence, severity, morbidity, and mortality are poorly documented in the literature.


METHODS
We describe the case of a patient who developed life-threatening diarrhea after surgery for UC and review the literature.


RESULTS
Eight cases have now been described in the literature. Small-bowel disease has developed up to 17 months after colectomy. Most cases responded to corticosteroid therapy. A single case in which this treatment was delayed was fatal.


CONCLUSIONS
This is a rare sequel to colectomy for UC, but one which is serious and can be fatal. If the diagnosis is made promptly, a full response to treatment can be expected and the long-term outlook is excellent.
Gooding
Ian R
IR
Centre for Medical and Surgical Gastroenterology and Hepatology, Princess Grace Hospital, London, United Kingdom. ian_gooding@yahoo.co.uk
Springall
Roger
R
Talbot
Ian C
IC
Silk
David B A
DB
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002675:Child, Preschool; D003082:Colectomy / Q000009:adverse effects*; D003093:Colitis, Ulcerative / Q000601:surgery*; D003967:Diarrhea; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D013997:Time Factors
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents