Ileostomy carcinomas a review: the latent risk after colectomy for ulcerative colitis and familial adenomatous polyposis.

Background: Ileostomy carcinoma after colectomy for ulcerative colitis and familial adenomatous polyposis is rare.

Methods: Forty-three case reports from the literature and a case of ours are reviewed.

Results: The risk of malignancy following ileostomy formation appears to be increased compared to the very low incidence of primary small bowel carcinoma. Chronic physical or chemical irritation of the stoma may predispose the ileal mucosa to colonic metaplasia with subsequent adenoma formation, dysplasia and invasive malignant change. This is particularly so where ileostomies are fashioned for familial adenomatous polyposis and ulcerative colitis.

Conclusions: Routine surveillance of patients who have had an ileostomy for 15 years or longer may lead to earlier detection of this complication.