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Case Report and Literature Review Illustrating the Clinical, Endoscopic, Radiologic, and Histopathologic Findings with Prepouch Ileitis after IPAA and Restorative Proctocolectomy for Refractory Ulcerative Colitis
Joint Authors
Cappell, Mitchell S.
Hakim, Seifeldin
Shams, Christienne
Amin, Mitual
Source
Case Reports in Gastrointestinal Medicine
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-07-30
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
Prepouch ileitis (PI) is an uncommon complication of ileal pouch anal anastomosis (IPAA) and restorative proctocolectomy (RPC) for treatment of refractory ulcerative colitis (UC).
A case is reported of PI in a 16-year-old girl who presented with severe UC that was initially stabilized with infliximab therapy but re-presented 1 year later with severe UC, refractory to infliximab and corticosteroid therapy, which required IPAA and RPC.
Her symptoms resolved postoperatively, but she re-presented 1 year later with 10 loose, bloody, bowel movements/day and involuntary 6-Kg weight-loss.
Computerized tomographic enterography showed focal narrowing and mucosal enhancement of the pouch and focal narrowing, abnormal mucosal enhancement, and mural thickening of the prepouch ileum.
Pouchoscopy revealed exudates and ulcerations in both the pouch and prepouch ileum up to 50 cm proximal to pouch, as confirmed by histopathology of pouch and ileal biopsies.
Capsule endoscopy revealed no small intestinal lesions beyond 50 cm from the pouch.
She required antibiotics, hydrocortisone enemas, and eventually azathioprine to control her symptoms.
She remains asymptomatic 4 years later while chronically administered azathioprine therapy.
Comprehensive literature review demonstrates that this case illustrates the classical clinical, radiologic, endoscopic, and histopathologic findings in PI, a relatively rare syndrome.
American Psychological Association (APA)
Shams, Christienne& Hakim, Seifeldin& Amin, Mitual& Cappell, Mitchell S.. 2018. Case Report and Literature Review Illustrating the Clinical, Endoscopic, Radiologic, and Histopathologic Findings with Prepouch Ileitis after IPAA and Restorative Proctocolectomy for Refractory Ulcerative Colitis. Case Reports in Gastrointestinal Medicine،Vol. 2018, no. 2018, pp.1-5.
https://search.emarefa.net/detail/BIM-1143586
Modern Language Association (MLA)
Shams, Christienne…[et al.]. Case Report and Literature Review Illustrating the Clinical, Endoscopic, Radiologic, and Histopathologic Findings with Prepouch Ileitis after IPAA and Restorative Proctocolectomy for Refractory Ulcerative Colitis. Case Reports in Gastrointestinal Medicine No. 2018 (2018), pp.1-5.
https://search.emarefa.net/detail/BIM-1143586
American Medical Association (AMA)
Shams, Christienne& Hakim, Seifeldin& Amin, Mitual& Cappell, Mitchell S.. Case Report and Literature Review Illustrating the Clinical, Endoscopic, Radiologic, and Histopathologic Findings with Prepouch Ileitis after IPAA and Restorative Proctocolectomy for Refractory Ulcerative Colitis. Case Reports in Gastrointestinal Medicine. 2018. Vol. 2018, no. 2018, pp.1-5.
https://search.emarefa.net/detail/BIM-1143586
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1143586