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Unique surgical approach to a twisted ileal-anal pouch

Buettner, Hannah
Kiely, Maria X.
Yao, Mengdi
Yoo, James
Chen, Lilian
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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.

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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

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DOI
10.1093/jscr/rjy133
PubMed ID
29942481
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© The Author(s) 2018. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com