Ileal Pouch–Anal Anastomosis Surgery: Imaging and Intervention for Post-operative Complications

Broder, Jennifer C.; Tkacz, Jaroslaw N.; Anderson, Stephan W.; Soto, Jorge A.; Gupta, Avneesh

doi:10.1148/rg.301095084

Cited by 52 publications

(20 citation statements)

References 15 publications

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“…Details of the surgical techniques employed (type of pouch, type and height of anastomosis) need to be clarified so that the radiologist is familiar with the postoperative anatomy. Computed tomography (CT), magnetic resonance imaging (MRI) and fluoroscopy all have a role 33 . Intestinal leakage from either the pouch-anal anastomosis or, less commonly, the blind end of the pouch with associated collections or abscesses may require ultrasound-or CT-guided drainage.…”

Section: Investigationmentioning

confidence: 99%

Intraoperative, postoperative and reoperative problems with ileoanal pouches

Sagar

Pembérton

2012

British Journal of Surgery

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Section: Investigationmentioning

confidence: 99%

Intraoperative, postoperative and reoperative problems with ileoanal pouches

Sagar

Pembérton

2012

British Journal of Surgery

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“…CT has become increasing important when an anastomotic stricture is being considered, and is now the preferred imaging modality in this particular setting, since it is able to demonstrate not only the anastomotic abnormality but extra-wall structures as well [ 1 ]. CT findings include focal bowel wall thickening at the anastomosis and distended proximal bowel loops filled with fluid or desiccated stool [ 31 ] (Fig. 17b ).…”

Section: Procedure-related Complicationsmentioning

confidence: 99%

Imaging the postoperative patient: long-term complications of gastrointestinal surgery

et al. 2015

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ObjectivesThe objectives of this review are (1) to become acquainted with the long-term complications of surgery of the gastrointestinal tract, and (2) to appreciate the appropriate use of imaging in the assessment of long-term complications.BackgroundGastrointestinal tract surgery comprises a group of procedures performed for a variety of both benign and malignant diseases. In the late postoperative setting, adhesions and internal hernias are the most important complications. and they can be further complicated by volvulus and ischemia. At present, computed tomography (CT) is the workhorse for evaluating late postoperative complications. Accurate imaging assessment of patients is essential for adequate treatment planning.Imaging findings or procedure detailsIn this pictorial essay we will review the most frequent long-term complications after gastrointestinal surgery, including adhesions, afferent loop syndrome, closed-loop obstruction, strangulated obstruction, internal hernias, external hernias, anastomotic strictures and disease recurrence. Examples will be depicted using iconography from the authors’ imaging department.ConclusionsKnowledge of the most frequent complications after gastrointestinal surgery in the late postoperative period is of paramount importance for every radiologist, so that potentially life-threatening situations can be promptly diagnosed and adequate therapy can be planned.Teaching points• Long-term postoperative complications of gastrointestinal tract surgery can be divided intoprocedure-relatedanddisease-relatedcategories.• The most commonprocedure-relatedcomplications are internal hernias and adhesions.• The most frequentdisease-relatedcomplications are mainly associated with neoplastic or inflammatory recurrence.• Computed tomography is the most useful examination when such complications are suspected.

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“…Detection of leaks resulting in pelvic abscesses is often performed with a pouchogram, pelvic MRI, or CT scan [56]. Use of a CT scan has the additional benefit of guiding drainage of associated pelvic abscess [58, 59]. Difficulties with pouch evacuation can be further assessed with a pouchogram (structural abnormalities), defecating pouchogram, scintigraphic pouch emptying studies, defecating/dynamic MRI, and anorectal manometry with balloon expulsion [60].…”

Section: Radiological Evaluation Of the Ileo-anal Pouchmentioning

confidence: 99%

Radiographical evaluation of ulcerative colitis

Deepak

2014

Gastroenterology Report

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Radiographical modalities have become important diagnostic tools in cases of ulcerative colitis (UC). Imaging can be used non-invasively to determine the extent of involvement, severity of disease and to detect disease-related complications and extra-intestinal inflammatory bowel disease (IBD) manifestations. While abdominal X-rays and barium enemas still retain their relevance in specific clinical settings, the use of computed tomography enterography (CTE) or magnetic resonance enterography (MRE) are now used as first-line investigations to exclude active small bowel disease in IBD patients and can be utilized to detect active colonic inflammation. Additionally, CT colonography and MR colonography are emerging techniques with potential applications in UC. Ultrasonography, leukocyte scintigraphy and positron emission tomography are novel abdominal imaging modalities currently being explored for IBD interrogations. This plethora of radiological imaging options has become a vital component of UC assessments.

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Ileal Pouch–Anal Anastomosis Surgery: Imaging and Intervention for Post-operative Complications

Cited by 52 publications

References 15 publications

Intraoperative, postoperative and reoperative problems with ileoanal pouches

Intraoperative, postoperative and reoperative problems with ileoanal pouches

Imaging the postoperative patient: long-term complications of gastrointestinal surgery

Radiographical evaluation of ulcerative colitis

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