Peristomal Pyoderma Gangrenosum Complicating Ulcerative Colitis

Abstract

A 45-year-old Japanese female underwent total colectomy and terminal ileostomy for intractable colitis with a recto-vaginal fistula．
Peristomal pyoderma gangrenosum developed 1 year after the operation．The stoma revision was performed when she underwent an emergent laparotomy for a strangulation ileus．Although she did not develop any gastrointestinal symptoms,peristomal pyoderma gangrenosum recurred at the new ileostomy site 19 months after the stoma revision．The recurrent peristomal pyoderma gangrenosum healed after amputation of the remnant rectum．Since then,she has not developed peristomal pyoderma gangrenosum for two years．Pyoderma gangrenosum is a rare but debilitating condition that occurs in patients with inflammatory bowel disease．ln contrast,peristomal pyoderma gangrenosum has been recognized only relatively recently,and is much less common．ln this case report,the characteristics and the treatment of peristomal pyoderma gangrenosum for the patient with inflammatory bowel disease are discussed．