Adenocarcinoma in the ileal pouch: late risk of cancer after restorative proctocolectomy

被引:75
作者
Heuschen, UA [1 ]
Heuschen, G [1 ]
Autschbach, F [1 ]
Allemeyer, EH [1 ]
Herfarth, C [1 ]
机构
[1] Univ Heidelberg, Dept Surg, D-69120 Heidelberg, Germany
关键词
ulcerative colitis; ileoanal pouch; backwash ileitis; pouchitis; adenocarcinoma;
D O I
10.1007/s003840000276
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Restorative proctocolectomy and ileal pouch-anal anastomosis is the surgical treatment of choice for patients with ulcerative colitis. As a long-term complication of this procedure, chronic pouchitis impairs the outcome in a number of patients. Aneuploidia and dysplasia have been observed after long-lasting inflammation of ileal mucosa. The question arises whether chronic inflammation of ileal mucosa predisposes to malignant transformation similar to the situation in the chronically inflamed colon. Cancer of the ileal mucosa has been reported in patients with Brooke's ileostomy and in patients with Kock pouch but not as yet in those with an ileoanal pouch. We report a patient with carcinoma in an ileoanal pouch originating from terminal ileal mucosa who had been suffering from pancolitis with longterm backwash ileitis before, and from chronic pouchitis after, restorative proctocolectomy. This case demonstrates the importance of regular follow-up with pouchoscopy and random biopsies in all patients with long-standing inflammation of the ileal mucosa.
引用
收藏
页码:126 / 130
页数:5
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