Rare complication after ileal pouch–anal anastomosis: Bilateral ureteral obstruction due to pelvic sepsis and retroperitoneal fibrosis

Restorative proctocolectomy with ileal pouch–anal anastomosis (IPAA) is the procedure of choice for the majority of patients who require surgery for ulcerative colitis, and the preferred operation for patients with familial adenomatous polyposis. Complications of IPAA are common, including septic, inflammatory, functional, neoplastic and metabolic complications. When early postoperative sepsis develops, subsequent failure over time is approximately five times the rate for the whole pouch population. The objective of this study was to report an uncommon complication of IPAA. We reported a case of a patient who developed bilateral ureteral obstruction due to retroperitoneal fibrosis secondary to pelvic sepsis after a pouch–anal anastomosis leak. To the best of our knowledge, no such case has ever been reported.