Prepouch ileitis, myth or reality? The first case with acute abdomen.

Restorative proctocolectomy with ileo pouch-anal anastomosis is a well established procedure for Ulcerative Colitis in selected patients. Pouchitis is a common condition in many patients after restorative proctocolectomy. A similar condition, named pre-pouch ileitis, characterised by inflammation proximal to the pouch has also been recently described. This condition is poorly understood and generally considered of little clinical relevance. We describe the first case of a potential life threatening complication from perforated ileitis of the new terminal ileum 2 years after restorative proctocolectomy for non-responder Ulcerative Colitis.