講演情報

[R2-5]潰瘍性大腸炎根治術後の難治性回腸嚢瘻より生じた回腸嚢癌の1例

志村 匡信1, 大北 喜基1, 北嶋 貴仁1,2, 家城 英治1, 嶌村 麻生1, 天白 成1, 山下 真司1, 今岡 裕基1, 川村 幹雄1, 奥川 喜永1,2, 浦谷 亮1, 市川 崇1,3, 安田 裕美1, 吉山 繁幸1, 小林 美奈子1,3, 大井 正貴1, 湯淺 博登4, 今井 裕4, 問山 裕二1 (1.三重大学大学院医学系研究科消化管小児外科学, 2.三重大学医学部附属病院ゲノム診療科, 3.三重大学大学院医学系研究科先端的外科技術開発学, 4.三重大学医学部附属病院病理診断科)
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The patient was a 39-year-old man. He performed restorative proctocolectomy (RPC) without covering ileostomy at the age of 24 because of refractory ulcerative colitis (UC). While he was suffering from anastomotic leakage, his family rejected to construct a diverting ileostomy after due consideration of his severe autism disorder. In spite of continuing in-hospital conservative treatment for 8 months, it was difficult to control pelvic infection due to anastomotic leakage. Finally, we performed diverting ileostomy construction, and he was discharged from hospital. After 11-years out-patient follow up in affiliated hospital, he was re-introduced to our hospital by left hydronephrosis and recurrent pyelonephritis due to refractory pelvic abscess. After CT-guided drainage, we performed ileal pouch resection. As a pathological finding, there were mucinous adenocarcinoma cells arising from refractory pouch fistula. In this time, we report a case who was diagnosed as ileal pouch cancer arising from refractory pouch fistula and re-consider about the follow-up management of UC patients with “non-functional pouch” after RPC.