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An unusual diverticulum adjacent to two large colonic polyps; a case report

Adenocarcinomas can arise in a variety of circumstances in which intestinal segments have been used for urinary diversions. Whereas ureterosigmoidostomy is the oldest and simplest form of continent urinary diversion it also seems to be the most dangerous in this regard. Herein we present a case of c...

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Published in:BMC gastroenterology 2018-06, Vol.18 (1), p.83-83, Article 83
Main Authors: Schembri, John, Bury, Jonathan, Hunt, Lesley, Riley, Stuart
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Hunt, Lesley
Riley, Stuart
description Adenocarcinomas can arise in a variety of circumstances in which intestinal segments have been used for urinary diversions. Whereas ureterosigmoidostomy is the oldest and simplest form of continent urinary diversion it also seems to be the most dangerous in this regard. Herein we present a case of colonic neoplasia complicating a non-functioning ureterosigmoidostomy after 55 years; the longest latent period documented to date. A 56-year-old lady born with congenital bladder exystrophy and who had a functional ileal conduit presented to us with a 6 month history of change in bowel habit and rectal bleeding. Prior to this she had had multiple abdominal surgeries as a child and had suffered from lifelong recurrent urinary tract infections. Colonoscopy revealed the presence of two large sessile polyps in close proximity to a diverticulum-like structure that after surgical resection turned out to be a non-functioning ureterosigmoidostomy from when she was an infant. Our case highlights the importance of enrolling patients with ureterosigmoidostomies into long-term colonoscopic surveillance programmes. This is also true for those patients who undergo revisional surgery but have preserved ureteric stumps. Endoscopists should be aware of the varied endoscopic appearances of the anastamosis in order to be able to recognise these structures when present.
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subjects Adenoma
Bladder
Care and treatment
Case Report
Case reports
Case studies
Colon
Colonic polyps
Colonoscopy
Colorectal cancer
Diverticulum
Endoscopy
Family medical history
Fecal incontinence
Gastroenterology
Intestine
Latent period
Medical screening
Ostomy
Patients
Polyps
Rectum
Surgery
Surveillance
Tumors
Ureter
Ureterosigmoidostomy
Urinary diversion
Urinary tract
title An unusual diverticulum adjacent to two large colonic polyps; a case report
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