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A patient experienced recurrent severe colitis after ileostomy closure, a condition previously unreported. Despite interventions, the cause of this severe colitis remains unidentified, highlighting a unique clinical challenge.

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery

Background:

  • A 50-year-old man with advanced rectal cancer underwent surgery including a diverting ileostomy.
  • The patient had a history of laparoscopic intersphincteric resection and partial liver resection for colorectal liver metastasis.

Observation:

  • Following ileostomy closure, the patient developed severe colitis with abdominal pain and fever.
  • Colonoscopy revealed multiple ulcers in the sigmoid colon and rectum.

Findings:

  • Despite antibiotic therapy and fasting, symptoms persisted, necessitating ileostomy reconstruction.
  • Severe colitis recurred after a second ileostomy closure, leading to a transverse colostomy.
  • Extensive examinations failed to identify the cryptogenic cause of the repetitive colitis.

Implications:

  • This case presents a rare instance of cryptogenic, repetitive severe colitis post-ileostomy closure.
  • The unexplained etiology of this colitis poses a diagnostic and therapeutic challenge.
  • Further investigation may be needed to understand the pathophysiology of post-ileostomy closure colitis.