Abstract
A case of adenocarcinoma developing in the pouch following restorative proctocolectomy is presented. This seems to be the third reported in the literature. The carcinoma developed from the remnants of precancerous rectal mucosa left in the muscular rectal cuff. The patient had been suffering from ulcerative colitis for 17 years prior to the development of the malignancy. He presented with features of subacute intestinal obstruction. Diagnosis was by sigmoidoscopic examination of the pouch and biopsy. He was treated with abdominoperineal resection of the pouch and rectum, followed by chemotherapy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Nicholls RJ, Belliveau P, Neill M, Wilks M, Tabaqchalis S. Restorative proctocolectomy with ileal reservoir: a pathophysiological assessment. Gut 1981;22:462–88.
Schrock TR. Complications of continent ileostomy. Am J Surg 1979;138:162–9.
Nilsson LO, Andersson H, Hulten L,et al. Absorption studies in patients six to 10 years after construction of ileostomy reservoirs. Gut 1979;20:499–503.
Philipson B, Brandberg A, Jagenburg R, Koch NG, Leger I, Ahren C. Mucosal morphology, bacteriology and absorption in intraabdominal ileostomy reservoir. Scand J Gastroenterol 1975;10:145–53.
Baker WN, Glass RE, Ritchie JK, Aylett SO. Cancer of the rectum following colectomy and ileorectal anastomosis for ulcerative colitis. Br J Surg 1978;65:862–8.
Grundfest SF, Fazio V, Weiss RA,et al. The risk of cancer following colectomy and ileorectal anastomosis for extensive mucosal ulcerative colitis. Ann Surg 1981;193:9–14.
Lennard-Jones JE, Morson BC, Ritchie JK,et al. Cancer in colitis—assessment of the individual risk by clinical and histological criteria. Gastroenterology 1977;73:1280–9.
Devroede GJ, Taylor WF, Sauer WJ,et al. Cancer risk and life expectancy in children with ulcerative colitis. N Engl J Med 1971;285:17–21.
McDougall IPM. The cancer risk in ulcerative colitis. Lancet 1964;2:655–8.
Morson BC. The large intestine. In: Saint W, Symens C, eds. Systemic pathology. London: Churchill Livingstone, 1978:1117–26.
Johnson WR, McDermott FT, Phil E, Hughes ES. Mucosal dysplasia: a major predictor of cancer following ileorectal anastomosis. Dis Colon Rectum 1983;26:697–700.
Heppell J, Weiland LH, Perrault J, Pemberton JH, Telander RL, Beart RW Jr. Fate of the rectal mucosa after rectal mucosectomy and ileoanal anastomosis. Dis Colon Rectum 1983;26:768–71.
Pemberton JH, Kelly KA, Beart RW Jr, Dozois RR, Wolff BG, Ilstrup DM. Ileal pouch-anal anastomosis for chronic ulcerative colitis: long term results. Ann Surg 1987;206:504–13.
Watson LC, Friedman HI, Griffin DC, Norton LW, Mellick PW. Small bowel neomucosa. J Surg Res 1980;28:280–91.
Hampton JM. Rectal mucosal stripping: a technique for preservation of the rectum after total colectomy for chronic ulcerative colitis. Dis Colon Rectum 1976;19:133–5.
Ravitch MM. Presidential Address: The reception of new operations. Ann Surg 1984;200:231–46.
Ravitch MM, Eidenheimer MC. Quoted in Pembertonet al.13.
Stern H, Walfish S, Mullen B, Mcleod R, Cohen Z. Cancer in an ileo-anal reservoir: a new late complication? Gut 1990;31:473–5.
Author information
Authors and Affiliations
About this article
Cite this article
Puthu, D., Rajan, N., Rao, R. et al. Carcinoma of the rectal pouch following restorative proctocolectomy. Dis Colon Rectum 35, 257–260 (1992). https://doi.org/10.1007/BF02051019
Issue Date:
DOI: https://doi.org/10.1007/BF02051019