Resolution of severe ulcerative colitis-associated benign stricture with combined vedolizumab and endoscopic stricturotomy: a case report

Ulcerative colitis (UC)-associated strictures, although infrequent, are complex to treat and often prompt surgical resection as a result of concerns about underlying malignancy. However, benign strictures resulting from the inflammation-induced fibrosis represent an important and underaddressed clinical scenario. Although endoscopic stricture therapy is well-established in Crohn's disease-associated strictures, its use in UC has not been described in the literature, to our knowledge. We report a case of a benign colonic stricture in a UC patient after a severe flare who achieved clinical remission with vedolizumab. Endoscopic stricturotomy was performed, resulting in sustained luminal patency over a 2-year follow-up period. Serial biopsies showed no dysplasia. The patient remained in clinical and endoscopic remission. This case suggests that combined medical and endoscopic therapy may promote the resolution of UC-associated benign strictures.