A Case of Refractory Pouchitis with Postoperative Anal Stenosis after Ileal Pouch-anal Anastomosis Treated with Vedolizumab, a Radial Incision and Cutting
Abstract
A 33-year-old man who had undergone total colectomy for refractory ulcerative colitis (UC) at 22 years of age was referred for severe pouchitis with anal stricture. The remission of pouchitis was achieved with vedolizumab (VDZ) treatment. However, as diarrhea improved, obstructive defecation symptoms became apparent due to the stricture. Repeated anal bougie dilation was unsuccessful. A radial incision and cutting were thus performed, and the defecation symptoms improved without recurrence for 1 year. This is the first case report demonstrating the effectiveness of a radial incision and cutting for the treatment of severe anal stenosis after ileal pouch-anal anastomosis, particularly in a short, fibrotic stricture site refractory to repeated bougie dilatation.
Related
- Simplification of the pouchitis scoring system and analysis of antibiotic treatment outcomes after ileal pouch-anal anastomosis for ulcerative colitis: based on the modified Pouchitis Disease Activity Index
- International practice patterns in the management of pouchitis: results from a global survey
- Vedolizumab use for severe chronic enterocolitis in a child with Hoyeraal–Hreidarsson syndrome: A case report
- Comparative Safety of Ustekinumab and Vedolizumab in Older Patients with Inflammatory Bowel Disease: A Bicentric Cohort Study
- Vedolizumab treatment in adults with immunodeficiency-associated enteropathy: a case series
BibTeX
@article{ishida2026case,
title = {{A Case of Refractory Pouchitis with Postoperative Anal Stenosis after Ileal Pouch-anal Anastomosis Treated with Vedolizumab, a Radial Incision and Cutting}},
author = {Anna Ishida and Yuichi Shimodate and Junya Sakaue and Yuki Ikeda and Naoyuki Nishimura and Kazuhiro Matsueda and Hirokazu Mouri and Motowo Mizuno},
journal = {Internal Medicine},
year = {2026},
month = sep,
doi = {10.2169/internalmedicine.7650-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7650-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - A Case of Refractory Pouchitis with Postoperative Anal Stenosis after Ileal Pouch-anal Anastomosis Treated with Vedolizumab, a Radial Incision and Cutting
AU - Anna Ishida
AU - Yuichi Shimodate
AU - Junya Sakaue
AU - Yuki Ikeda
AU - Naoyuki Nishimura
AU - Kazuhiro Matsueda
AU - Hirokazu Mouri
AU - Motowo Mizuno
PY - 2026
DA - 2026/09/22
JO - Internal Medicine
DO - 10.2169/internalmedicine.7650-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7650-26/_article
AB - A 33-year-old man who had undergone total colectomy for refractory ulcerative colitis (UC) at 22 years of age was referred for severe pouchitis with anal stricture. The remission of pouchitis was achieved with vedolizumab (VDZ) treatment. However, as diarrhea improved, obstructive defecation symptoms became apparent due to the stricture. Repeated anal bougie dilation was unsuccessful. A radial incision and cutting were thus performed, and the defecation symptoms improved without recurrence for 1 year. This is the first case report demonstrating the effectiveness of a radial incision and cutting for the treatment of severe anal stenosis after ileal pouch-anal anastomosis, particularly in a short, fibrotic stricture site refractory to repeated bougie dilatation.
SN - 1349-7235
SN - 0918-2918
ER -