Cytomegalovirus Infection of the Ileoanal Pouch

• DOI: 10.1097/mib.0b013e3182a52553
• Publication Date: 2013-08-23T09:37:10Z
• Authors: Jeffrey D. McCurdy; Edward V. Loftus; William J. Tremaine; Thomas C. Smyrk; David H. Bruining; Darrell S. Pardi; Laura E. Raffals; John B. Kisiel; Nayantara Coelho-...; Sunanda V. Kane; William A. Faubion; Konstantinos A. P...
• Keywords: Pouchitis; Pouch; Proctocolectomy; Primary Sclerosing Cholangitis

Up to 30% of cases pouchitis are felt have a secondary cause. Cytomegalovirus (CMV) may represent possible etiopathological agent. Here, we report our experience with CMV involvement the pouch, including risk factors, clinical features, and pouch outcomes in patients inflammatory bowel disease after proctocolectomy ileal pouch-anal anastomosis.The pathology database at Mayo Clinic Rochester was searched between January 1995 October 2012 for tissue diagnosis following anastomosis.Seven inclusions were identified. The median age 35 (range, 10-53) years, majority female (71%). Five (71%) on immunosuppressive medications 4 who had undergone orthotopic liver transplantation primary sclerosing cholangitis. presentation similar among all patients: diarrhea (86%), fever (71%), abdominal pain (57%). All mucosal inflammation, 71% having focal ulcerations 60% changes prepouch ileum. improved ganciclovir. None required excision or recurrent infection. Three nonspecific pouchitis.A high index suspicion is needed diagnose pouch. An increase stool frequency immune suppression those failed empiric antibiotics should prompt assessment Antiviral therapy seems be effective, postinfection seem favorable, particularly presenting their first episode pouchitis.