A CASE OF FAMILIAL ADENOMATOUS POLYPOSIS ACCOMPANIED WITH DESMOID IN INTESTINAL ANASTOMOTIC SITE

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 59; no. 5; pp. 1336 - 1340
• Main Authors: MABUCHI, Hideaki, NISHIGUCHI, Kanji, TANIGAWA, Nobuhiko, NAKATA, Eiji, OKUZAWA, Masaaki, OHTA, Masayuki, INOUE, Hitoshi, KODAMA, Shinichiro
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 25.05.1998
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.59.1336

Desmoid associated with familial adenomatous polyosis (FAP) presents difficulty in its complete extripation and recurs in a high frequency, and hence, we have difficulties in the treatment. This paper reports an extremely rare case of FAP accompanied with desmoid in an intestinal anastomotic site. A 28-year-old man who had a family history of FAP associated with intractable intra-abdominal desmoid was diagnosed as having FAP. Total colectomy, ileo-anal anastomosis and diverting ileostomy were performed under a diagnosis of FAP accompanied with colonic cancers. After closure of the ileostomy, he had ileus symptoms, for that a laparotomy was performed. The desmoid was observed in the intestinal anastomotic site at the closure of ileostomy. Resection of the corresponding anastomotic site and ileostomy were carried out because the desmid was considered to be the origin of intestinal obstruction. Although the recent aggresive surgical treatment has much improved the prognosis of the patients with FAP, the development of the desmoid seems one of the unfavourable prognostic factors. We think that the appropriate operative procedures to prevent desmoid development may be necessary for improvement of the prognosis of FAP's families with intractable intra-abdominal desmoids like this case.