Multiple adenomatous polyps arising in a continent reservoir ileostomy

In a 29-year-old man who presented with leakage from a continent ileostomy after proctocolectomy, endoscopic evaluation of the reservoir revealed extensive adenomatous polyposis. The polyps were not present at the time of revision of the reservoir 4 years earlier. Because it was not possible to fashion an adequate nipple valve in the presence of so many polyps and the concern over possible malignant transformation, the reservoir was excised. This is the second reported case of polyposis involving a continent reservoir ileostomy. Patients with a continent ileostomy constructed after proctocolectomy for polyposis coli should be evaluated endoscopically at regular intervals.