CASE REPORT
 
KEYWORDS
TOPICS
ABSTRACT
Reconstructive proctocolectomy is the method of choice in the surgical treatment of ulcerative colitis (UC). It allows maintenance of the natural way of passing stools. However, the created intestinal reservoir may cause many metabolic and functional problems for patients. Often, inflammation of the mucous membrane of the intestinal reservoir (pouchitis) may occur. This is the most common complication among patients undergoing reconstructive proctocolectomy. The etiology of this phenomenon is not fully understood, but intestinal microbiota is of great importance. Incidents of inflammation occur in approximately 45% of patients with a pouch [1]. As a rule, drug treatment is used; however, severe cases with poor reservoir function are an indication of removal of the reservoir and definitive ileostomy. The case report presents the severe complications occurring after reconstructive proctocolectomy, which ultimately contributed to the death of the patient.
Siek J, Sysiak-Sławecka J, Czuj W. Patient with complications after reconstructive proctocolectomy due to Colitis Ulcerosa – case report and literature review. J Pre-Clin Clin Res. 2025; 19(1): 9–14. doi: 10.26444/jpccr/203282
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