Emergency Total Proctocolectomy In An Uninsured Patient With Familial Adenomatous Polyposis Syndrome And Acute Lower Gastrointestinal Hemorrhage In A Community Hospital: A Case Report

Highlights • It is recommended to manage Familial Adenomatous Polyposis Syndrome with initial genetic screening, followed by yearly colonoscopy from 10-40 years of age. • It is unclear what the optimal treatment option is for cases of Familial Adenomatous Polyposis Syndrome presenting with acute low...

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Bibliographic Details
Published in:International journal of surgery case reports 2016-01, Vol.26, p.166-169
Main Authors: Oviedo, Rodolfo J., MD, FACS, Dixon, Bruce M., BA, Sofiak, Chase, BS
Format: Article
Language:English
Subjects:
Case Report
Surgery
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Summary:Highlights • It is recommended to manage Familial Adenomatous Polyposis Syndrome with initial genetic screening, followed by yearly colonoscopy from 10-40 years of age. • It is unclear what the optimal treatment option is for cases of Familial Adenomatous Polyposis Syndrome presenting with acute lower gastrointestinal hemorrhage with hemodynamic compromise that is unresponsive to conservative management. • A total proctocolectomy is a feasible option in the emergency setting in a patient with FAP in critical condition due to severe lower GI bleeding and who does not have resources or insurance. A staged ileal J pouch to anal anastomosis is much easier to justify to the hospital in an uninsured patient compared to a staged completion colectomy with proctectomy. • It is essential to monitor the ileo-anal anastomosis with anoscopy
ISSN:2210-2612
2210-2612
DOI:10.1016/j.ijscr.2016.07.052