Mucosal proctectomy and ileoanal anastomosis

The classical surgical therapy of ulcerative colitis and familial polyposis has been total proctocolectomy and ileostomy. In order to avoid a cutaneous stoma and to achieve continence without disruption of gastrointestinal continuity, responding to a demand particularly among younger patients, a mucosal proctectomy in association with an ileoanal anastomosis has been devised. The addition of an ileal reservoir proximal to the anastomosis results in fewer bowel movements and a greater degree of continence. In our series of 70 cases, we have analyzed the normal roentgen anatomy of the ileoanal anastomosis and the proximal ileal reservoir and present our findings on plain film and contrast examinations. To assess patients postoperatively, the radiologist should be aware of the basic surgery involved and the normal roentgen anatomy resulting from this procedure.