Takayasu's arteritis after total proctocolectomy for ulcerative colitis: Report of a case

PURPOSE: Although coexistence of Takayasu's arteritis with ulcerative colitis is often reported, all these cases have been in patients whose colons were in situ. The aim of the present study was to describe a patient who developed Takayasu's arteritis after total proctocolectomy for ulcerative colitis. METHODS: The clinical course of a 42-year-old female who developed Takayasu's arteritis after total proctocolectomy for ulcerative colitis is described and the literature reviewed. RESULTS: Symptomatic arteritis developed in the left carotid artery four months after total proctocolectomy with ileal J-pouch-anal anastomosis for ulcerative colitis. Peristomal pyoderma gangrenosum, multiple ulcers in the oral cavity, and leakage at the ileoanal anastomosis were observed simultaneously. High-dose therapy with steroids proved effective for the arteritis, pyoderma gangrenosum, and multiple oral ulcers. We finally excised the ileal pouch with anus because of the intractable leakage three years after the occurrence of Takayasu's arteritis. CONCLUSIONS: This patient illustrates the possibility that Takayasu's arteritis is an extraintestinal complication of ulcerative colitis even after surgical removal of the colon.