Unique surgical approach to a twisted ileal-anal pouch. Issue 6 (15th June 2018)

• Record Type: Journal Article
• Authors: Buettner, Hannah; Kiely, Maria X; Yao, Mengdi; Yoo, James; Chen, Lilian
• Is Part Of: Journal of surgical case reports. Issue 6(2018)
• Publication Date: 2018-06-15
• Subjects: Surgery -- Periodicals; Surgery -- Case studies -- Periodicals; 617.005
• DOI: 10.1093/jscr/rjy133
• Languages: English
• ISSNs: 2042-8812

Abstract

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.