Two-time perforation of the ileal J-pouch 6 and 18 years after restorative proctocolectomy and ileal pouch-anal anastomosis for familial adenomatous polyposis : a case report

Shibata, Kengo; Ebinuma, Shota; Sakamoto, Sodai; Suzuki, Asami; Terasaki, Yasunobu; Taketomi, Akinobu

Two-time perforation of the ileal J-pouch 6 and 18 years after restorative proctocolectomy and ileal pouch-anal anastomosis for familial adenomatous polyposis : a case report

Shibata, Kengo; Ebinuma, Shota; Sakamoto, Sodai et al.

Surgical case reports, 2022, 8(1), 2

Permalink : https://hdl.handle.net/2115/83936

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アクセス権	metadata only access
URI	https://hdl.handle.net/2115/83936
タイトル	Two-time perforation of the ileal J-pouch 6 and 18 years after restorative proctocolectomy and ileal pouch-anal anastomosis for familial adenomatous polyposis : a case report
著者	Shibata, Kengo ; Ebinuma, Shota ; Sakamoto, Sodai ; Suzuki, Asami ; Terasaki, Yasunobu ; Taketomi, Akinobu
著者名 Shibata, Kengo
著者名 Ebinuma, Shota
著者名 Sakamoto, Sodai
著者名 Suzuki, Asami
著者名 Terasaki, Yasunobu
e-Rad_Researcher 70363364 著者名 Taketomi, Akinobu
言語	英語
キーワード	Familial adenomatous polyposis
	Ileal pouch-anal anastomosis
	Restorative proctocolectomy
	Perforation
発行日	2022
出版者	Springer
収録物名	Surgical case reports
巻(号)	8(1)
ページ	2
抄録	Background Perforation of the ileal J-pouch after restorative proctocolectomy and ileal pouch-anal anastomosis are extremely rare. There has been no report of perforation of the ileal J-pouch occurring twice over several years. We report the first case of perforation at 6 and 18 years following restorative proctocolectomy. Case presentation The patient was a 52-year-old man who underwent a two-stage restorative proctocolectomy with a hand-sewn ileal J-pouch anal anastomosis due to familial adenomatous polyposis and sigmoid colon cancer at 34 years of age. At the age of 40, he underwent ileal pouch resection at its blind end, abdominal drainage, and anastomotic dilatation. The patient had a perforation of the blind end of the ileal J-pouch from increased intraluminal pressure, with anastomotic stricture and pervasive peritonitis. The patient had no symptoms for a few years; however, 18 years after the initial surgery and 12 years after the first perforation, the patient presented with severe abdominal pain. Computed tomography demonstrated pneumoperitoneum; accordingly, laparotomy was performed. Upon opening the abdominal cavity, contaminated ascites and inflammatory changes were documented involving the ileum. A 2-mm perforation involving the blind end of the ileal J-pouch was also observed and repaired, followed by temporary loop ileostomy creation. Postoperative endoscopy revealed an ulcer in the ileal J-pouch and a stricture located directly at the anastomosis. Conclusions The blind end of the J-pouch repeatedly perforated over the years due to recurrent anastomotic stricture. Regular surveillance is, therefore, considered necessary for the release of stricture, maintenance of anastomotic patency, and prevention of ileal J-pouch perforation.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
PISSN	2198-7793
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1186/s40792-021-01355-9