The case of familial adenomatous polyposis and a proposal for the system of dispensarisation

Czech version

Authors: J. Trna ¹; L. Husová ¹; M. Oliverius ²; M. Dastych jr. ¹; M. Šenkyřík ¹; V. Příbramská ¹
Authors‘ workplace: Interní hepatogastroenterologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jan Lata, CSc. ¹; Klinika transplantační chirurgie IKEM Praha, přednosta prof. MUDr. Miloš Adamec, CSc. ²
Published in: Vnitř Lék 2009; 55(6): 587-592
Category: Case Reports

Overview

We present a case of a 46 years old female with familial adenomatous polyposis of the colon. The adenocarcinoma had been treated using all available oncology therapeutic modalities. Late post‑radiation changes caused ileus that required acute surgical revision, and formation of difficult-to-define enterovesical fistula that led to recurring urosepsis. When the conservative methods, including enteral and, subsequently, home total parenteral nutrition, were unsuccessful, the patient underwent successful surgery with resection of the affected intestinal loops, part of the bladder, evacuation of an abscess in the small pelvis and terminal jejunostomy. As a result of this procedure, the patient is now able to take food per os without infectious complications. The resulting short bowel syndrome is managed by administration of additional parenteral nutrition and registration of the patient for intestinal transplantation is being considered.

Key words:
familial adenomatous polyposis – colorectal adenocarcinoma – radiation therapy complications – enterovesical fistula – FAP patients dispensarisation

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