Laparoscopic rectopexy for recurrent volvulus of <scp>J</scp> pouch after total proctocolectomy and ileal pouch anal anastomosis

Lee, Suet‐Ying; Fok, Ka‐Lung; Cheung, Hester Yui Shan; Tang, Chung‐Ngai

doi:10.1111/1744-1633.12072

Cited by 3 publications

(4 citation statements)

References 7 publications

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“…All the publications were in English. Two publications were in abstract form [22, 27], four were letters to the editor [14, 16, 23, 24], and the remaining were full-text articles. There was one case series reporting six patients [26] and 15 case reports reporting one patient each.…”

Section: Resultsmentioning

confidence: 99%

Volvulus of the ileal pouch–anal anastomosis: a meta-narrative systematic review of frequency, diagnosis, and treatment outcomes

Jawoosh

Haffar²,

Deepak

et al. 2019

Gastroenterology Report

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Background Proctocolectomy with ileal pouch–anal anastomosis (IPAA) is the surgical procedure of choice for medically refractory ulcerative colitis and familial adenomatous polyposis. While rare, a pouch volvulus can occur. We aimed to determine the frequency, presentation, and management approach of pouch volvulus in patients with IPAA. Methods A systematic search of published literature was performed by a medical reference librarian on 10 August 2018 and two independent reviewers identified relevant publications, extracted data, and assessed the methodological quality based on a validated tool. A retrospective review of the Mayo Clinic electronic medical records identified one case of pouch volvulus between January 2008 and August 2018. Results The frequency of pouch volvulus from one large published study reporting long-term outcomes of IPAA was 0.18% (3/1,700). A total of 22 patients (18 ulcerative colitis) were included (median age 32 years, 73% females). Median time to volvulus after IPAA was 36 months while median interval to volvulus diagnosis from symptom onset was 24 hours. Abdominal pain was the most commonly reported symptom (76%). The diagnosis was made primarily by abdominal computed tomography (13/17 patients, 76%). Endoscopic treatment was successful in 1 of 11 patients (9%). Surgery was performed in 20 patients and pouch-pexy and pouch excision were the most frequent surgical operations. A redo IPAA was performed in five patients (25%). Conclusion Pouch volvulus is a rare but serious complication of IPAA and should be suspected even in the absence of obstruction symptoms. Endoscopic treatment often fails and surgery is effective when performed early.

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Section: Resultsmentioning

confidence: 99%

Volvulus of the ileal pouch–anal anastomosis: a meta-narrative systematic review of frequency, diagnosis, and treatment outcomes

Jawoosh

Haffar²,

Deepak

et al. 2019

Gastroenterology Report

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“…The patient's primary volvulus was treated by endoscopic decompression and a unilateral pexy after which she recovered uneventfully. The patient was said to have "a free-floating pouch without any adhesions between the pouch and the sacral hollow" [15], an observation also reported by all of the seven cases that we found in the literature [10][11][12][13][14][15][16]. One year later, the patient was diagnosed with a further volvulus for which she underwent a pouchoscopy and exploratory laparoscopy.…”

Section: Figure 3: Flexible Pouchoscopy Revealing a "Spokes Of A Whee...mentioning

confidence: 78%

“…To our knowledge, there is a dearth of case reports on patients with recurrent pouch volvulus after undergoing a total proctocolectomy and IPAA surgery. After an extensive PubMed search, we found only seven other cases that presented with recurrent pouch volvulus [10][11][12][13][14][15][16]. In five out of these seven cases, the initial volvulus was treated by decompression and a unilateral pouch pexy; however, this pexy did not suffice as the patient re-presented with a further volvulus [10,11,[14][15][16].…”

Section: Figure 3: Flexible Pouchoscopy Revealing a "Spokes Of A Whee...mentioning

confidence: 99%

Recurrent Pouch Volvulus Following Ileoanal J-Pouch Anastomosis: A Case Report

Alabdulrahman

Stuart

Smith

et al. 2023

Cureus

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For individuals suffering from severe refractory ulcerative colitis (UC) who are unresponsive to medical treatment, a total proctocolectomy and ileal pouch-anal anastomosis (IPAA) surgery is the gold-standard treatment. However, its complications include anastomotic leaks, pelvic or perianal abscesses, and rare complications such as pouch volvulus. To our knowledge, there is a scarcity of case reports on patients with, specifically, a recurrent pouch volvulus. We present a case of a 57-year-old female with refractory UC who had undergone this treatment with no initial complications; 15 years later, she presented with intermittent bouts of obstruction. An exploratory laparotomy was performed; however, no adhesions or necrosis were found. Following investigations, pouch volvulus was confirmed. She subsequently underwent four endoscopic decompressions in the same year and ultimately received an enteropexy of the pouch. The volvulus reoccurred and, ultimately, the decision was made to perform a loop ileostomy. The patient, to date, is alive and doing well with her permanent ileostomy.

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“…According to 6,7 Both patients had an uneventful recovery and remained asymptomatic during their follow up. Furthermore, in 3/14 cases there was a successful endoscopic detorsion of the pouch followed by insertion of a flatus tube, but patient's symptoms recurred during the next 24 hours.…”

Section: Surgical Technique: Recurrencementioning

confidence: 99%

A rare case of obstructive ileus due to ileal pouch torsion: a case report and systematic review

et al. 2020

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Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become the standard surgical treatment for ulcerative colitis patients. Among others, it is important for clinicians to be aware of a rare, though urgent situation, the ileal pouch torsion. A high degree of suspicion is essential as obstruction due to pouch torsion is not likely to resolve conservatively. Delay in diagnosis and treatment can lead to pouch jeopardy and life-threatening complications. The aim of this study was to present a systematic review of the literature combined with the presentation of a case report of our department regarding this rare entity. A systematic literature review according to QUORUM guidelines was conducted in July 2019 using MEDLINE, SCOPUS, and COCHRANE databases. We included studies reporting pouch torsion after IPAA in English or German language with no restriction regarding publication time. Outcomes after different treatment options, such as operative pouch detorsion, and/or pouchpexy, and/or pouch reconstruction, and/or end-ileostomy through laparoscopic or open procedures were evaluated. We identified 170 publications. After duplicates and irrelevant articles have been excluded, 25 publications remained for full-text review. Finally, 12 articles were included in this systematic review, concerning 14 cases. To the best of our knowledge, this is the first comprehensive systematic review on this topic to date.

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Laparoscopic rectopexy for recurrent volvulus of J pouch after total proctocolectomy and ileal pouch anal anastomosis

Cited by 3 publications

References 7 publications

Volvulus of the ileal pouch–anal anastomosis: a meta-narrative systematic review of frequency, diagnosis, and treatment outcomes

Volvulus of the ileal pouch–anal anastomosis: a meta-narrative systematic review of frequency, diagnosis, and treatment outcomes

Recurrent Pouch Volvulus Following Ileoanal J-Pouch Anastomosis: A Case Report

A rare case of obstructive ileus due to ileal pouch torsion: a case report and systematic review

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