Obstructing inflammatory fibroid polyp in pelvic ileal reservoir after restorative proctocolectomy in ulcerative colitis. Report of a case

Dis Colon Rectum. 1994 Oct;37(10):1034-7. doi: 10.1007/BF02049320.

Abstract

Purpose: This study was designed to describe clinical, endoscopic, and histopathologic features of an inflammatory fibroid polyp occurring in the pelvic ileal reservoir after restorative proctocolectomy in ulcerative colitis.

Method: A case report describing the clinical course of such a patient is presented.

Results: Three years postoperatively, the patient developed diarrhea, anemia, weight loss of 10 kg, and symptoms of obstructed defecation. Ileoscopy showed pouchitis and a polypoid tumor filling the pouch. Biopsies revealed chronic inflammation without signs of malignancy. At laparotomy, a 5 cm x 3.5 cm x 3.5 cm submucosal, solid, circumscribed tumor was found within the pouch, and histopathologic examination yielded the diagnosis. The pelvic pouch was resected and replaced by a Brooke ileostomy. During 18 months of follow-up, the course has been uneventful.

Conclusion: Inflammatory fibroid polyp is a rare, reactive, non-neoplastic lesion, which, for the first time, is reported in a pelvic ileal reservoir. It may cause pouch dysfunction. It is always benign but may masquerade as a malignant tumor.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Colitis, Ulcerative / surgery*
  • Endoscopy, Gastrointestinal
  • Fibroma / diagnosis
  • Fibroma / etiology*
  • Fibroma / surgery
  • Follow-Up Studies
  • Humans
  • Ileal Neoplasms / diagnosis
  • Ileal Neoplasms / etiology*
  • Ileal Neoplasms / surgery
  • Ileostomy
  • Inflammation / diagnosis
  • Inflammation / etiology
  • Intestinal Obstruction / diagnosis
  • Intestinal Obstruction / etiology*
  • Intestinal Obstruction / surgery
  • Intestinal Polyps / diagnosis
  • Intestinal Polyps / etiology*
  • Intestinal Polyps / surgery
  • Male
  • Proctocolectomy, Restorative / adverse effects*
  • Reoperation