Pouchitis and extraintestinal manifestations of inflammatory bowel disease after ileal pouch-anal anastomosis.

摘要: Although the etiology of pouchitis after ileal pouch-anal anastomosis (IPAA) is unknown, its manifestations resemble those nonspecific inflammatory bowel disease, including, anecdotally, apparent ability to evoke extraintestinal (EIM) disease (IBD). Our aim was determine in what manner and EIMs were associated. The computerized records 819 consecutive patients who underwent IPAA between January 1981 December 1988 reviewed. Eighty-five excluded (because incomplete follow-up, death, or permanent ileostomy). Follow-up remaining 734 complete (mean, 41 months). mean age 32 years ratio men women 1:1. Ileal performed for chronic ulcerative colitis 91% familial adenomatous polyposis 9%. Pouchitis occurred 31% 6% (p less than 0.01). time first occurrence 17 months. recurred 61% at risk. Patients with preoperative postoperative had significantly higher rates did without (39% versus 26% no EIMs, p 0.001; 53% 25% 0.001). Of whom resolved but then (n = 12), when abated treated seven patients. We concluded that frequently risk developing never EIMs. Furthermore some experienced a temporal relationship flares pouchitis. These results imply may be novel manifestation persisting operation.