Gastrointestinal tract is the most common locality for well-differentiated neuroendocrine tumors (NET). While their occurrence in patients with ulcerative colitis (UC) is uncommon, it has been well documented. However, the causal relationship between development of NET and chronic intestinal inflammation or dysplasia remains controversial. The presence of NET in the ileal pouch in UC patients has been described only in a few reports to date. In this article, we present a case of such a tumor arising in the pouch in a patient with primary sclerosing cholangitis-associated UC, who underwent a restorative proctocolectomy with ileal pouch anal anastomosis and liver transplantation. The case is supported by a review of a relevant literature. Correspondence address: Ondrej Fabian Clinical and Transplant Pathology Centre Institute for Clinical and Experimental Medicine Videnska 1958/9 Prague, 14021 Czech Republic ondrej.fabian@ikem.cz; ondrejfabian5@gmail.com.

• Klíčová slova
• Ulcerative colitis, carcinoid, neuroendocrine tumor, pouch, ulcerative colitis,
• MeSH
• lidé MeSH
• nádory ilea patologie   chirurgie   MeSH
• neuroendokrinní nádory * patologie   chirurgie   MeSH
• pouch * patologie   MeSH
• proktokolektomie rekonstrukční * škodlivé účinky   MeSH
• sklerozující cholangitida * patologie   komplikace   MeSH
• ulcerózní kolitida * patologie   komplikace   chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH

BACKGROUND AND AIMS: We sought to define the prevalence and to characterize possible predictive factors of Crohn's disease (CD) occurring in children with ulcerative colitis (UC) after ileal pouch-anal anastomosis (IPAA). METHODS: This was a multicenter, retrospective study including 15 centers of the Porto IBD group of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition. Children with a confirmed diagnosis of UC undergoing colectomy with IPAA and a minimal follow up of 6 months were identified. The following data were collected: demographic data; endoscopic and histologic data; disease activity; laboratory exams; therapeutic history; indication for surgery, type, and timing; and IPAA functional outcomes and complications. In de novo CD cases, time of diagnosis, phenotype, location, and therapies were gathered. RESULTS: We identified 111 UC children undergoing IPAA from January 2008 to June 2018 (median age at colectomy: 13 years; age range: 1-18 years; female/male: 59/52). The median time from diagnosis to colectomy was 16 (range, 0-202) months. At the last follow-up, 40 (36%) of 111 children developed pouchitis. The criteria for de novo CD were met in 19(17.1%) of 111 children with a 25-month median (range, 3-61 months). At last follow-up, 12 (63.1%) of 19 were treated with biologics and in 5 (26.3%) of 19 children, the pouch was replaced with definitive ileostomy. In a multivariable logistic regression model, decreased preoperative body mass index z scores (odds ratio, 2.2; 95% confidence interval, 1.1-4.4; P = .01) resulted as the only variable associated with CD development. CONCLUSIONS: Children with UC undergoing IPAA carry a high risk of developing subsequent CD. De novo CD cases showed decreased preoperative body mass index z scores, identifying a poor nutritional status as a possible predictive factor.

This is the largest European study describing the prevalence of Crohn’s disease (CD) development in children with ulcerative colitis undergoing subtotal colectomy with ileal pouch–anal anastomosis. Children affected by ulcerative colitis carry a higher risk when compared with adults to develop de novo CD after surgery. On the other hand, the multivariate analysis identified decreased values of preoperative body mass index z scores as a possible predictor of new-onset CD.

• Klíčová slova
• children, colectomy, de novo Crohn’s disease, ileoanal pouch anastomosis, ulcerative colitis,
• MeSH
• Crohnova nemoc * chirurgie   MeSH
• dítě MeSH
• kojenec MeSH
• kolektomie škodlivé účinky   MeSH
• lidé MeSH
• mladiství MeSH
• následné studie MeSH
• pooperační komplikace etiologie   epidemiologie   MeSH
• pouchitis * etiologie   epidemiologie   MeSH
• předškolní dítě MeSH
• proktokolektomie rekonstrukční * škodlivé účinky   MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• ulcerózní kolitida * chirurgie   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

AIM: The comparison of quality of life after gastrectomy. METHOD: Quality of life after gastrectomy is compared in open, prospective, randomised trial. The group with Roux-en-Y reconctruction and "J-pouch" reconstruction are compared. "J-pouch" is created using interponate jejunum loop with keeping duodenum in passage. The standardized questionnaire according to Eypasch is tool for comparison of quality life. The statistical evaluation was performed using Student t-test. RESULTS: 67 patients were analyzed altogether. The average quality of life in the group with Roux-en-Y reconstruction was 92.6 points and in the "J-pouch" group was 102.5 points. The statistical comparison of quality of life using Student t-test in the group with Roux-en-Y and "J-pouch" reconstructions confirmed significant difference (p = 0.0067). CONCLUSION: Quality of life in patient after gastrectomy represents the most important factors after surgery. The standardised questionnaries help to quantify quality of life and provide the necessary data for evidence based medicine. The statistical comparison confirmed the higher quality of life in patients with "J-pouch" reconstruction. The possibility of reconstruction providing better nutrition and higher quality of life should be considered.

• MeSH
• dospělí MeSH
• gastrektomie * MeSH
• kvalita života * MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory žaludku chirurgie   MeSH
• pouch * MeSH
• Rouxova Y-anastomóza MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

The majority of patients with Crohn's disease and a proportion of patients with ulcerative colitis will ultimately require surgical treatment despite advances in diagnosis, therapy, and endoscopic interventions. The surgical procedures that are most commonly done include bowel resection with anastomosis, strictureplasty, faecal diversion, and ileal pouch. These surgical treatment modalities result in substantial alterations in bowel anatomy. In patients with inflammatory bowel disease, endoscopy plays a key role in the assessment of disease activity, disease recurrence, treatment response, dysplasia surveillance, and delivery of endoscopic therapy. Endoscopic evaluation and management of surgically altered bowel can be challenging. This consensus guideline delineates anatomical landmarks and endoscopic assessment of these landmarks in diseased and surgically altered bowel.

• MeSH
• anastomóza chirurgická metody   MeSH
• anatomická značka diagnostické zobrazování   MeSH
• chirurgie trávicího traktu škodlivé účinky   MeSH
• Crohnova nemoc diagnóza   chirurgie   MeSH
• dospělí MeSH
• endoskopie metody   MeSH
• idiopatické střevní záněty chirurgie   MeSH
• konsensus MeSH
• lidé středního věku MeSH
• lidé MeSH
• pouch škodlivé účinky   MeSH
• proktokolektomie rekonstrukční metody   MeSH
• recidiva MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• stenóza chirurgie   MeSH
• střeva anatomie a histologie   patologie   chirurgie   MeSH
• stupeň závažnosti nemoci MeSH
• ulcerózní kolitida diagnóza   chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Research Support, N.I.H., Extramural MeSH