Ileocaecal Crohn’s disease and familial adenomatous polyposis in one patient – a case report

Abstract

Crohn’s disease (CD) and Familial adenomatous polyposis (FAP) are two different diseases which both affect gastrointestinal tract. FAP is an autosomal dominant inherited disease, however the etiology of CD is still unknown but is supposed to be multifactorial (genetics, environment, immune state, microbiom). The therapy of these two diseases differs as well. The ultimate solution for FAP is surgery (colectomy or proctocolectomy). On the other hand, the therapy of CD can be either conservative or surgical. Generally, in cases of bowel resections the alternatives of gastrointestinal tract restoration have to be considered in advance. Furthermore, this decision is even more demanding in patients diagnosed with both diseases (CD and FAP). We present a case of a young female with FAP who was recently diagnosed with active CD in the ileocaecal region. Due to large multiple colon polyps and stenotic terminal ileum she was indicated for surgery (colectomy with terminal ileostomy and terminal ileum resection). Subsequently, the ileorectal anastomosis was constructed in this case. In further text, we also discuss other types of possible bowel restoration solutions (ileal pouch-anal anastomosis and abdominoperineal resection with terminal ileostomy) in such a patient.