Volvulus of an ileal pouch-rectal anastomosis after subtotal colectomy for ulcerative colitis: report of a case

Arima, Kei; Watanabe, Masayuki; Iwatsuki, Masaaki; Ida, Satoshi; Ishimoto, Takatsugu; Nagai, Yoshinori; Iwagami, Shiro; Baba, Yoshifumi; Sakamoto, Yasuo; Miyamoto, Yuji; Baba, Hideo

doi:10.1007/s00595-013-0724-0

Cited by 12 publications

(9 citation statements)

References 10 publications

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“…Volvulus of the small bowel following IPAA is rare and to our knowledge only 6 cases have been reported in the literature with only 3 of them involving the ileal pouch itself 7–13 ( Table 1 ). Our case being the first documentation on volvulus of an S-type ileal pouch.…”

Section: Discussionmentioning

confidence: 99%

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Volvulus of ileal S-pouch: A rare complication of ileal pouch anal anastomoses

Tyagi

Gupta

Verma

et al. 2014

International Journal of Surgery Case Reports

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INTRODUCTIONIleal pouch anal anastomosis (IPAA) after total proctocolectomy is a frequently performed surgery for medically refractory ulcerative colitis (UC). Volvulus of the ileal pouch as a complication of IPAA is extremely rare. We present a case of volvulus of S-type ileal pouch.PRESENTATION OF CASEA 28 year old male, with history of total proctocolectomy with IPAA for severe UC in 2009 presented with signs of bowel obstruction. Emergency laparotomy was done and a volvulus of the S-type ileal pouch was derotated and pouchpexy done.DISCUSSIONThe IPAA has a wide spectrum of complications, with obstruction of proximal small bowel occurring frequently. Volvulus of the ileal pouch is extremely rare with only 3 reported cases. Early diagnosis and intervention is important to salvage the pouch. Computed tomography (CT) may aid the diagnosis in stable patients.CONCLUSIONThe diagnosis of ileal pouch volvulus although rare, should be kept in mind when dealing with patients complaining of recurrent obstruction following IPAA.

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Section: Discussionmentioning

confidence: 99%

“…The usefulness of endoscopy in diagnosis or reduction of volvulus is doubtful with cases of unsuccessful attempts 11 and even a perforation 8 had been reported.…”

Section: Discussionmentioning

confidence: 99%

Volvulus of ileal S-pouch: A rare complication of ileal pouch anal anastomoses

Tyagi

Gupta

Verma

et al. 2014

International Journal of Surgery Case Reports

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“…There are only a few case reports in literature. [45][46][47][48] CT scan helps with diagnosis and may show SBO, with signs of mesenteric twisting and signs of ischemia. 48 Immediate surgical intervention is recommended to prevent pouch ischemia and necrosis.…”

Section: Vovlulusmentioning

confidence: 96%

Ileal J Pouch Complications and Surgical Solutions

Sherman

Greenstein

2014

Inflammatory Bowel Diseases

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Ileal pouch-anal anastomosis is currently accepted as the standard method to restore continence after total proctocolectomy for medically refractory ulcerative colitis and familial adenomatous polyposis. Ileal pouches offer improved quality of life and high patient satisfaction; however, there are many pouch-related complications due to the original disease process and change in anatomy. This is a review article of the common and some rare surgical complications after J pouches, which can be subdivided into the septic and nonseptic categories. Septic-related complications include anastomotic leak, abscess, and fistulas, whereas common nonseptic-related complications include small bowel obstruction, strictures, Crohn's disease, pouchitis, and cuffitis. Rare nonseptic complications to be discussed are prolapse, volvulus, and neoplasia.

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“…Mild obstruction due to acute angulation without torsion may be managed with self-catheterization. For frank torsion, surgical consultation and laparoscopic reduction typically are required (21,22). Pouch Prolapse.-Pouch prolapse (Fig 9) is rare, with a reported prevalence of 0.3%.…”

Section: Efferent Limb Syndrome-acute Angulation or Torsion Of The Pmentioning

confidence: 99%

J Pouch: Imaging Findings, Surgical Variations, Natural History, and Common Complications

et al. 2018

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Ileal pouch-anal anastomosis, or J pouch, surgery has become the procedure of choice for treatment of medically refractory ulcerative colitis and familial adenomatous polyposis. Overall, this operation is associated with a low rate of postoperative morbidity and good long-term function. However, when complications develop, there is a heavy reliance on imaging to facilitate an accurate diagnosis. Reported postoperative complication rates range from 5% to 35%. Complications generally can be categorized as structural, inflammatory, or neoplastic conditions. Structural complications include leaks, strictures, afferent and efferent limb syndromes, and pouch prolapse. Inflammatory conditions include cuffitis, pouchitis, and Crohn disease of the pouch. In addition, a variety of neoplastic conditions can develop in the pouch. Overall, pouchitis and leaks are the most common complications, occurring in up to 50% and 20% of individuals, respectively. Many imaging modalities are used to evaluate the J pouch and associated postoperative complications. The indications and various surgical techniques for J pouch surgery, normal postoperative appearance of the pouch, and most common associated complications are reviewed. In addition, the various imaging findings associated with J pouch surgery are described and illustrated. The radiologist's familiarity with the potential complications of the pouch can facilitate appropriate imaging, hasten an accurate diagnosis, and aid in rendering proper management. RSNA, 2018.

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Volvulus of an ileal pouch-rectal anastomosis after subtotal colectomy for ulcerative colitis: report of a case

Cited by 12 publications

References 10 publications

Volvulus of ileal S-pouch: A rare complication of ileal pouch anal anastomoses

Volvulus of ileal S-pouch: A rare complication of ileal pouch anal anastomoses

Ileal J Pouch Complications and Surgical Solutions

J Pouch: Imaging Findings, Surgical Variations, Natural History, and Common Complications

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