Volvulus of ileal S-pouch: A rare complication of ileal pouch anal anastomoses

Abstract INTRODUCTION Ileal pouch anal anastomosis (IPAA) after total proctocolectomy is a frequently performed surgery for medically refractory ulcerative colitis (UC). Volvulus of the ileal pouch as a complication of IPAA is extremely rare. We present a case of volvulus of S-type ileal pouch. PRES...

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Bibliographic Details
Published in:International journal of surgery case reports 2014-01, Vol.5 (10), p.717-719
Main Authors: Tyagi, Gaurav, Gupta, Utsav, Verma, Ankit, Saxena, Dhananjay, Mittal, Atul, Goyal, Amit, Kankaria, Jeevan, Jenaw, R.K
Format: Article
Language:English
Subjects:
Ileal pouch volvulus
Ileal S-pouch
IPAA
Pouchpexy
Surgery
Volvulus
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Summary:Abstract INTRODUCTION Ileal pouch anal anastomosis (IPAA) after total proctocolectomy is a frequently performed surgery for medically refractory ulcerative colitis (UC). Volvulus of the ileal pouch as a complication of IPAA is extremely rare. We present a case of volvulus of S-type ileal pouch. PRESENTATION OF CASE A 28 year old male, with history of total proctocolectomy with IPAA for severe UC in 2009 presented with signs of bowel obstruction. Emergency laparotomy was done and a volvulus of the S-type ileal pouch was derotated and pouchpexy done. DISCUSSION The IPAA has a wide spectrum of complications, with obstruction of proximal small bowel occurring frequently. Volvulus of the ileal pouch is extremely rare with only 3 reported cases. Early diagnosis and intervention is important to salvage the pouch. Computed tomography (CT) may aid the diagnosis in stable patients. CONCLUSION The diagnosis of ileal pouch volvulus although rare, should be kept in mind when dealing with patients complaining of recurrent obstruction following IPAA.
ISSN:2210-2612
2210-2612
DOI:10.1016/j.ijscr.2014.07.005