Case Report
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 21, 2005; 11(43): 6888-6890
Published online Nov 21, 2005. doi: 10.3748/wjg.v11.i43.6888
Secondary pouchitis in a post-operative patient with ulcerative colitis, successfully treated by salvage surgery
Yuji Toiyama, Toshimitsu Araki, Shigeyuki Yoshiyama, Chikao Miki, Masato Kusunoki
Yuji Toiyama, Toshimitsu Araki, Shigeyuki Yoshiyama, Chikao Miki, Masato Kusunoki, The Second Department of Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr Masato Kusunoki, The Second Department of Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan. kusunoki@clin.medic.mie-u.ac.jp
Telephone: +81-59-2315294 Fax: +81-59-2326968
Received: March 22, 2005
Revised: April 23, 2005
Accepted: April 26, 2005
Published online: November 21, 2005
Abstract

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.

Keywords: Ulcerative colitis, Ileal pouch-anal anastomosis, Secondary pouchitis, Salvage operation