A Case of Jejunal Fistulas by Late Appearance of Intra-abdominal Abscesses after Total Colectomy for Ulcerative Colitis

Abstract

We report a case of jejunal fistula due to late-appearing intraabdominal abscesses following ulcerative colitis (UC) surgery. A 52-year-old man who underwent total colectomy and ileal pouch anal canal anastomosis after perforation of the descending colon and panperitonitis during steroid treatment for ulcerative colitis. Histological examination of the resected specimen showed acute fulminating type of UC. He was admitted due to fever 6 months after surgery. Ultrasonography (US) and computed tomography (CT) showed an intraabdominal abscess in the upper left quadrant. X-ray examination with contrast medium showed an abscess cavity and 2 fistulas between the abscess cavity and jejnum, necessitating partial resection of the jejunam and drainage of the abscess cavity. Resected specimens did not show ulcerative colitis or Crohn's disease. After discharge, he was readmitted for fever and leukocytosis. X-ray examination with contrast medium showed the abscess cavity and an other fistula between the abscess cavity and jejnum. We conducted further partial resection of the jejunum and drainage after abscess curettage. The resected specimen did not show ulcerative colitis or Crohn's disease. The man has had no recurrence of symptoms or diagnostic imaging signs since discharge.