Traumatic perforation of ileal pouch. Report of a case.

A 28-year-old woman with a previous history of restorative proctocolectomy for complicated ulcerative colitis had acute onset of severe abdominal pain that was diagnosed at another hospital as a perforated peptic ulcer. Careful history-taking revealed that she had blunt trauma to the abdomen one day before admission. Laparotomy detected a perforation hole at the afferent loop of the ileal pouch. Debridement and primary closure of the perforation, with temporary decompression of the pouch, resulted in a good outcome. With the increasing popularity of selecting restorative proctocolectomy for the treatment of polyposis coli and ulcerative colitis, more and more pouches will be constructed. Possible perforation of the ileal pouch should be considered when such patients present with a perforated hollow viscus. With appropriate management, the pouch can be saved. Review of the literature revealed no similar reports.