[Complications related to surgery in ulcerative colitis, pouchitis, special sequelae--internal medicine viewpoint]

There are indications that pouchitis after ileal pouch-anal anastomosis is a remanifestation of the underlying disease--ulcerative colitis--under different conditions. A small group (approximately 5-10% of the patients) develops chronic severe pouchitis with total villus atrophy. It has recently been shown that even high-grade dysplastic epithelial changes and DNA aneuploidy occur in chronic pouchitis. Thus, surveillance programs might be necessary for these patients. Pouchitis is a clinical model to study the pathogenesis of chronic destructive mucosal inflammation systematically.