Surgical decision for a young woman with familial adenomatous polyposis

Sile Johnson, Chris Cunningham
2020 Journal of the Nuffield Department of Surgical Sciences  
Familial adnomatous polyposis (FAP) is a disease characterised by a multitude of polyps (hundreds to thousands), most often present in the colon, which have pre-malignant potential. The condition is due to a mutation in the adenomatous polyposis coli (APC) gene. Although the majority of these cases are inherited, a significant proportion arise due to a de novo mutation. The definitive treatment for the condition is surgery, but with multiple surgical options available, it is important to
more » ... important to consider the trifecta of best evidence, clincial judgement and patient values in the selection process. In the present case report, a 36-year old woman diagnosed with FAP presented with a small bowel obstruction upstream of her stoma. Eight months previosuly, she underwent a panproctocolectomy and ileostomy with the creation of a ileal-pouch. The surgery was necessary as there was a suspected rectosigmoid cancer seen on CT. Reported is the information pertaining to her recent stay in hospital following the obstruction but the discussion explores the multi-faceted approach to determining which type of surgery was most suitable for this patient.
doi:10.37707/jnds.v1i3.75 fatcat:d5e3k2a4tzajxosq5gajvml4hq