A Case of Small Bowel Cancer with Crohn's Disease arising from Ileal Pouch after Total Colectomy

Hideaki Kawashima, Masahiro Ishigooka, Motoya Kashiyama, Setsuji Takanashi, Takashi Hara, Sayuki Yamazaki, Hiromi Hatakeyama and Yoshio Hosokawa

Department of Surgery, Kin-I-Kyo Chuo Hospital

Small bowel cancer in Crohn's disease is reportedly increasing, but remains extremely rare in Japan. We report a 44-year old woman with adenocarcinoma of the terminal ileum who underwent total colectomy and ileo-anal anastomosis 10 years earlier for preoperative diagnosis of ulcerative colitis and had been treated for Crohn's disease, diagnosed when she was 35 years old, using 5'-ASA, predonisolone, and azathioprin. She reported left side hip pain and was admitted on August 19, 2003, for further examination. Small bowel cancer detected in the ileal pouch had developed to about 10 cm size in diameter. She underwent abdomino-perineal resection of the ileal pouch and anus and chemotherapy. The curatively resected tumor had no lymph node involvement and no recurrence has been seen as of this writing. Because small bowel cancer may occur in Crohn's disease or ileal pouch, regular follow-up is recommended.

Key words
Crohn's disease, small bowel cancer, ileal pouch

Reprint requests
Hideaki Kawashima Department of Surgery, Kin-I-Kyo Chuo Hospital
10-2-15-1 Fushiko, Higashi-ku, Sapporo, 007-8505 JAPAN

Accepted
November 30, 2004

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