Unique surgical approach to a twisted ileal-anal pouch
Buettner, Hannah ; Kiely, Maria X. ; Yao, Mengdi ; Yoo, James ; Chen, Lilian
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Keywords
colectomy
ulcerative colitis
anastomosis
surgical
intestine
repeat surgery
stomas
surgical procedures
ileoanal anastomosis
anus
ileum
morbidity
proctocolectomy
Digestive System
Digestive System Diseases
Gastroenterology
Pathological Conditions, Signs and Symptoms
Surgery
Surgical Procedures, Operative
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Abstract
Total proctocolectomy with ileal pouch-anal anastomosis can restore gastrointestinal continuity in patients requiring colectomy for ulcerative colitis, however, it can be associated with high morbidity. Reoperation for pouch-related complications is technically challenging and often leads to deterioration of pouch function or need for permanent stoma. We report a case of acute on chronic small bowel obstruction secondary to a 360-degree twist in the small bowel introduced during creation of the ileal-anal pouch. Our novel approach at repair has not been reported in past literature which included resection and re-anastomosis of the small bowel proximal to the pouch allowing for pouch salvage with return to function.
Source
J Surg Case Rep. 2018 Jun 15;2018(6):rjy133. doi: 10.1093/jscr/rjy133. eCollection 2018 Jun. Link to article on publisher's site