Radiology of the continent ileostomy reservoir: II. Findings in patients with late complications

Lycke, K. G.; Göthlin, Jan; Jensen, J; Philipson, B. M.; Kock, N. G.

doi:10.1007/bf00203485

Cited by 10 publications

(4 citation statements)

References 5 publications

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“…Of 54 patients with the radiologic diagnosis slight inflammation, 29 were classified as having slight changes at endoscopy, but 25 were endoscopically normal. Most likely, the reason for the discrepancy between radiology and endoscopy is that the reservoirs over time lose some of their normal mucosal pattern (2) and that these changes were interpreted as inflammation on radiographs. Mucosal biopsy specimens of normally functioning continent ileostomies display slight to moderate inflammatory changes in most patients (6), and specimens therefore would not have been helpful in these cases.…”

Section: Double-contrast Barium Examination Has Been Reported Tomentioning

confidence: 98%

Comparison between Radiologic and Endoscopic Evaluation of the Continent Ileostomy Reservoir

Lycke

Göthlin

Jensen

et al. 1993

Scandinavian Journal of Gastroenterology

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The present study was performed to compare the results of radiologic examination and endoscopy in 156 patients with continent ileostomy reservoirs. Data from clinical follow-up and findings at revisional surgery were used for confirmation of diagnosis. One hundred and one patients had the clinical diagnosis nonspecific inflammation, 48 had symptoms of valve dysfunction, and 7 were studied because of suspected valve-shunting fistulas. For moderate and severe inflammation the findings on radiographs and at endoscopy were in accordance, whereas slight inflammation was more frequently reported by radiology than endoscopy. Radiology overdiagnosed slight inflammation. One disadvantage of endoscopy in patients with inflammation was that the afferent ileal segment could be reached in only 56%. By radiology 41 of 44 defective valves were identified (93%), whereas endoscopy disclosed only 24 defective valves (55%). The combined efforts of radiologic examination and endoscopy only managed to diagnose three of the seven patients with valve-shunting fistulas (two by radiologic and one by endoscopic examination). In conclusion, the retrograde double-contrast examination is a valuable complement in the assessment of patients with continent ileostomies and appears to be superior to endoscopy in the diagnosis of valve dysfunction and in depicting the afferent ileal segment.

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Section: Double-contrast Barium Examination Has Been Reported Tomentioning

confidence: 98%

Comparison between Radiologic and Endoscopic Evaluation of the Continent Ileostomy Reservoir

Lycke

Göthlin

Jensen

et al. 1993

Scandinavian Journal of Gastroenterology

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“…Endoscopic access to the afferent ileal limb may be difficult and a contrast radiological pouchogram may be more useful, but radiology may over‐diagnose inflammation . Carefully performed and interpreted contrast radiology examinations are capable of correctly diagnosing the nature of valve malfunction in up to 96% of cases .…”

Section: Continent Ileostomy – the Kock Pouchmentioning

confidence: 99%

“…Whilst double‐contrast barium examinations have generally been superseded by cross‐sectional imaging and water‐soluble contrast studies, large historical barium radiological studies provide a useful reference for the understanding of Kock pouch anatomy and dysfunction . These studies highlight the importance of dynamic studies to diagnose valve eversion and slippage, for example use of the Valsalva manoeuvre and removal of the catheter, whose presence may be artificially stabilizing a faulty valve . In the future, dynamic MRI may prove useful in this regard.…”

Section: Continent Ileostomy – the Kock Pouchmentioning

confidence: 99%

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in surgery for inflammatory bowel disease

et al. 2018

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Aim There is a requirement of an expansive and up to date review of surgical management of inflammatory bowel disease (IBD) that can dovetail with the medical guidelines produced by the British Society of Gastroenterology. Methods Surgeons who are members of the ACPGBI with a recognised interest in IBD were invited to contribute various sections of the guidelines. They were directed to produce a procedure based document using literature searches that were systematic, comprehensible, transparent and reproducible. Levels of evidence were graded. An editorial board was convened to ensure consistency of style, presentation and quality. Each author was asked to provide a set of recommendations which were evidence based and unambiguous. These recommendations were submitted to the whole guideline group and scored. They were then refined and submitted to a second vote. Only those that achieved >80% consensus at level 5 (strongly agree) or level 4 (agree) after 2 votes were included in the guidelines. Results All aspects of surgical care for IBD have been included along with 157 recommendations for management. Conclusion These guidelines provide an up to date and evidence based summary of the current surgical knowledge in the management of IBD and will serve as a useful practical text for clinicians performing this type of surgery.

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“…To achieve this, we analyzed all examinations in w h i c h t h e r e s u l t s w e r e r e p o r t e d as n o r m a l d u r i n g a n 8 -y e a r p e r i o d ( 1 9 8 0 t h r o u g h 1987). I n a s e p a r a t e article, w e w i l l e x a m i n e t h e r o l e o f r a d i o l o g y in t h e d i a g n o s i s o f c o m p l i c a t i o n s o f ileal r e s e r v o i r s [17].…”

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confidence: 99%

Radiology of the continent ileostomy reservoir: I. Method of examination and normal findings

et al. 1994

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The aim of the present study is to describe the radiologic methods used to study continent ileostomy reservoirs and to depict the normal radiologic features and variations identified by these procedures. During an 8-year period, 408 double-contrast studies were performed in 261 patients. The present study comprises 170 examinations in 99 patients with normal findings. A high-density barium contrast medium and air were used. Modes variation in the size and shape of the reservoirs was observed. The mucosal pattern of the reservoirs resembled that of the ileum but the folds were slightly wider. The continence-providing valves were 3-5 cm long and had a diameter of 2.5-4.0 cm. The diameter of the afferent ileal segments was usually slightly larger than that of more proximal ileal segments, with an upper limit of approximately 4 cm. The efferent ileal segments generally had a straight course without widening or out-pouches. Retrograde barium double-contrast examination is a satisfactory method for the evaluation of continent ileostomy reservoirs. Here we define the range of normal variations of such reservoirs as seen on retrograde double-contrast radiologic examinations.

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Radiology of the continent ileostomy reservoir: II. Findings in patients with late complications

Cited by 10 publications

References 5 publications

Comparison between Radiologic and Endoscopic Evaluation of the Continent Ileostomy Reservoir

Comparison between Radiologic and Endoscopic Evaluation of the Continent Ileostomy Reservoir

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in surgery for inflammatory bowel disease

Radiology of the continent ileostomy reservoir: I. Method of examination and normal findings

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