[A case of ulcerative colitis with recurrence and new-onset extraintestinal manifestations during treatment for refractory proctitis and pouchitis after ileal pouch-anal anastomosis].

A female patient in her late 20s, with a history of ulcerative colitis since adolescence, underwent ileoanal canal anastomosis for ulcerative colitis. She developed diarrhea, rectal pain, and pyoderma gangrenosum and underwent resection of the remaining rectum and ileal pouch-anal anastomosis. One year postoperatively, she developed ileocolitis, left sacroiliitis, and right dorsal foot pain, which were diagnosed as extraintestinal manifestations, and adalimumab was effective. The patient should be introduced to biologic agents at an earlier stage, considering the possibility of flare-ups or the emergence of new extraintestinal complications when inflammation is present in the residual postoperative rectal mucosa and ileocecal sac.