Barreiro-de Acosta Manuel, Bastón-Rey Iria, Calviño-Suárez Cristina, Enrique Domínguez-Muñoz J
Gastroenterology Department, University Hospital of Santiago de Compostela, A Coruña, Spain.
United European Gastroenterol J. 2020 Apr;8(3):256-262. doi: 10.1177/2050640619900571. Epub 2020 Jan 13.
Pouchitis is a frequent complication in ulcerative colitis patients after proctocolectomy with ileal pouch-anal anastomosis. It is an unspecific inflammation of the pouch with unknown aetiology. First-line treatment for acute and chronic pouchitis is antibiotics. Some cases of severe chronic refractory pouchitis may benefit from biological treatment. Anti-tumour necrosis factor should be recommended as the first option, leaving the new biologicals for multirefractory patients. Permanent ileostomy may be an option in severe cases, after failure of medical treatment. Prophylaxis therapy with a probiotic mixture is recommended after the first episode of pouchitis, whereas it is not clear whether probiotics are useful for all patients after surgery. Here, we present a case report and review the treatment options in different forms of pouchitis.
袋炎是溃疡性结肠炎患者行直肠结肠切除术后回肠储袋肛管吻合术常见的并发症。它是储袋的一种非特异性炎症，病因不明。急性和慢性袋炎的一线治疗是使用抗生素。一些严重的慢性难治性袋炎病例可能从生物治疗中获益。应推荐抗肿瘤坏死因子作为首选，将新型生物制剂留给多重难治性患者。在药物治疗失败后，严重病例可选择永久性回肠造口术。袋炎首次发作后，建议使用益生菌混合物进行预防性治疗，而益生菌对所有术后患者是否有用尚不清楚。在此，我们报告一例病例并回顾不同类型袋炎的治疗选择。
