De Deken Julie, Stavrou Gregor A
Department of General, Visceral and Thoracic Surgery, Surgical Oncology, Klinikum Saarbrücken, Saarbrücken, Germany.
J Surg Case Rep. 2022 Dec 30;2022(12):rjac609. doi: 10.1093/jscr/rjac609. eCollection 2022 Dec.
Proctocolectomy with ileostomy is an established surgical treatment in patients with inflammatory bowel disease. Adenocarcinoma of an ileostomy is a rare complication in long-term ileostomies. We present the case of a 69-year-old man who presented with bloody stools and a tumour at the ileostomy site 37 years after ileostomy formation. Biopsies confirmed the presence of an adenocarcinoma. Imaging did not show any metastases or advanced local infiltration. A resection of the ileostomy with a broad safety margin and reimplantation of a new Ileostomy was performed. At 18-month follow-up, there is no sign of recurrence. Ileostomy adenocarcinoma in a Crohn's disease patient is rare with only four cases described in literature. An en-bloc resection and relocation of the ileostomy is the recommended treatment. Education of patients and healthcare professionals on this long-term ileostomy complication is vital for the early diagnosis and treatment.
全结直肠切除术加回肠造口术是炎症性肠病患者已确立的外科治疗方法。回肠造口腺癌是长期回肠造口患者中罕见的并发症。我们报告一例69岁男性患者，在回肠造口形成37年后出现便血及回肠造口部位肿瘤。活检证实为腺癌。影像学检查未显示任何转移或局部进展性浸润。进行了带足够安全切缘的回肠造口切除术及新回肠造口再植术。在18个月的随访中，无复发迹象。克罗恩病患者发生回肠造口腺癌很罕见，文献中仅描述了4例。推荐的治疗方法是整块切除并重新安置回肠造口。对患者及医护人员进行关于这种长期回肠造口并发症的教育对于早期诊断和治疗至关重要。
