Recurrent XXXX in the ileo-anal pouch or rectum in @entity1412 .

@entity1 @entity1127 @entity706 @entity5 @entity254 @entity1412 @entity189 @entity6523 @entity652
Most small bowel @entity1127 in @entity1412 ( @entity1412 ) occur in the peri-ampullary region, and distal small bowel @entity652 and @entity189 are comparatively less common. As standard therapy in @entity1412 consists of proctocolectomy with ileal pouch anal @entity254 , or @entity254 , it is essential to be aware of the potential for @entity6523 formation in the terminal ileum and rectum. Ileal @entity652 are found in 9-20% of @entity1 with @entity1412 , and new @entity1127 may develop after colectomy. @entity706 and @entity1127 are 2-4 times more common than @entity652 , may be indistinguishable from @entity652 on examination (requiring biopsy for diagnosis), and tend to regress after colectomy. @entity652 may arise in pouches, usually after an interval of several years, and have been documented to occur in the terminal ileum up to 25 years after colectomy. At pouch construction, rectal mucosectomy may theoretically fail to remove all mucosa at risk. Small islets of rectal mucosa may remain after this technically difficult operation, and the late development of @entity5 , up to 20 years postoperation has been noted. A stapled @entity254 may arguably have a better physiological result, but a greater amount of residual rectal mucosa may increase late @entity5 risk. Annual endoscopic follow-up of pouches is recommended. All @entity1127 or suspicious lesions should be biopsied, excised or destroyed, preserving a sample for histology. After @entity254 , @entity5 risk in the rectal stump increases with chronological age, with risk ranging from 5-10% at age 50 years, to 14-29% at age 60 years. Surveillance of the rectal stump in @entity1412 is recommended every 4-6 months. There may be a role for prostaglandin synthesis inhibitors in some @entity1 .
