3 years follow‐up of a twisted ileoanal pouch

Swarnkar, Keshav; Hopper, N.; Ryder, Jessica; Feroz, A.; Stephenson, B. M.

doi:10.1111/j.1463-1318.2004.00575.x

Cited by 9 publications

(5 citation statements)

References 4 publications

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“…The flow diagram of different phases of this systematic review is shown in Figure 1. We identified 16 publications from nine countries published between 1993 and 2018 that met the selection criteria [14–29] and we reported an additional case from the Mayo Clinic identified in the database search. Thirteen studies were found by the librarian search, two by the Google Scholar search [14, 19], and one from reference lists of relevant papers [28].…”

Section: Resultsmentioning

confidence: 99%

“…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%

“…A redo IPAA was offered to five patients after pouch-pexy or pouch excision. In one case, the anastomosis was defunctioned with a perineal ileostomy [14] (Table 1).…”

Section: Resultsmentioning

confidence: 99%

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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%

Section: Resultsmentioning

confidence: 99%

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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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“…Diagnosis of this condition typically requires a high degree of suspicion, CT, and gastrografin enema. The patients reported in the literature have been managed surgically with adhesiolysis and derotation and fixing the pouch with or without revision of the ileorectal anastomosis [ 5 , 6 , 8 , 9 ]. Twists can be managed with an endoscopic approach, which avoids the need for a large open surgical procedure that can be technically challenging due to severe adhesions and might lead to increased complications and prolonged hospital stay.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic management of obstructing pouch twist

Pokala

Shen

2022

Gastroenterology Report

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“…Ulcerative colitis is a chronic idiopathic inflammatory disease of the colorectal mucosa. This disease affects approximately 500,000 to 1,000,000 people in the United States [2][3][4][5]; 25% -33% of whom require some form of surgical treatment [6]. Restorative proctocolectomy with ileal pouch anal anastomosis is the surgical treatment of a choice in patients with medically refractory disease or evidence of dysplasia.…”

Section: Introductionmentioning

confidence: 99%

Long-axis rotational volvulus in an ileal J-pouch anal anastomosis: A preventable rare complication

George¹,

Fajardo²

2014

CRCM

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Puropose: This study was designed to report a very rare long-term complication of ileal-Jpouch anal anastomosis: An 180 degree longaxial rotational volvulus causing J pouch obstruction. Methods: An Ovid and Medline search using the following keywords was performed: J pouch ileoanal anastomosis, J-pouch ileoanal anastomosis complications, J-pouch volvulus, J-pouch complications, restorative proctocolectomy complications, and restorative proctocolectomy volvulus. One J-pouch ileoanal anastomosis 180˚ volvulus report was found [1]. Result: We describe a long-axis 180˚ rotational volvulus complication of a J-pouch ileoanal anastomosis. The J pouch was performed three years prior after the laparoscopic total proctocolectomy for chronic ulcerative colitis. Pouch excision and new ileoanal J-pouch surgery were then performed along with pexy using alloderm mesh placement with excellent outcomes. Conclusion: Long-axis 180˚ rotational volvulus is a rare complication of a J-pouch ileoanal anastomosis. Pouch dysfunction after a long-axis rotational volvulus is an uncommon cause of acute abdomen. Lack of adhesions and pouch size are risk factors for the pouch torsion. Prompt diagnosis and treatment are essential for the pouch salvage. Simple abdominal x-ray, barium enema and CT scan represent important tools for diagnosis. Salvage surgery should be performed even if detorsion and decompression of the affected bowel are achieved. Surgery has excellent outcomes if performed after the prompt diagnosis. Pouch pexy should be done to prevent recurrent volvulus.

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3 years follow‐up of a twisted ileoanal pouch

Cited by 9 publications

References 4 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

Endoscopic management of obstructing pouch twist

Long-axis rotational volvulus in an ileal J-pouch anal anastomosis: A preventable rare complication

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