case_images: PMC11300533_01
case_images: Esophagogastroduodenoscopy revealed no abnormal findings in the duodenum before stoma closure (a) and continuous diffuse friable mucosa and edema (b, c). Biopsy revealed diffuse inflammatory cell infiltration, cryptitis, and crypt abscesses (hematoxylin and eosin staining. Magnification x20) (d).
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case_images: Esophagogastroduodenoscopy and pouchoscopy performed before stoma closure revealed no abnormal findings in the duodenum and focal inflammation of the pouch body (Figures 1a and 2a). Esophagogastroduodenoscopy revealed continuous diffuse friable mucosa and edema in the duodenum (Figure 1b,c). Duodenum biopsy revealed diffuse inflammatory cell infiltration, cryptitis, and crypt abscesses, and pouch biopsy revealed numerous neutrophilic infiltrations (Figures 1d and 2d).
case_images: Pouchcoscopy revealed no abnormal findings before stoma closure (a) and multiple ulcers and purulent mucus adhesion when he visited our department (b, c). The biopsy revealed numerous neutrophilic infiltrations (hematoxylin and eosin staining. Magnification x20) (d).
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case_images: Esophagogastroduodenoscopy and pouchoscopy performed before stoma closure revealed no abnormal findings in the duodenum and focal inflammation of the pouch body (Figures 1a and 2a). Pouchoscopy revealed edema, friability, loss of vascular pattern, mucous exudates, and ulceration (the endoscopic subscore of pouchitis disease activity index of 5; Figure 2b,c). Duodenum biopsy revealed diffuse inflammatory cell infiltration, cryptitis, and crypt abscesses, and pouch biopsy revealed numerous neutrophilic infiltrations (Figures 1d and 2d).
case_images: Clinical course of the patient
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case_images: Treatment with oral prednisolone (40 mg/day) and ciprofloxacin was initiated (Figure 3).
case_images: Esophagogastroduodenoscopy revealed scattered inflammatory polyps in the duodenum (a, b), and pouchcoscopy revealed that the ulcers and erosions had disappeared (c, d).
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case_images: Nine months after UPA initiation, esophagogastroduodenoscopy revealed scattered inflammatory polyps and no active inflammatory findings in the duodenum (Figure 4a,b). Pouchoscopy revealed remitted mucosa with vascular permeability, and the ulcers and erosions had disappeared (modified pouchitis disease activity index of 0; Figure 4c,d).