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Clinical Manifestations:
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Murine Ileocolic Bowel Resection with Primary Anastomosis
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Ileal J-Pouch Perforation: Case Report.

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    A patient with familial adenomatous polyposis experienced a J-pouch perforation after colectomy. Surgical repair and ileostomy led to recovery, with normal endoscopic findings six months later.

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    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Colorectal Surgery

    Background:

    • Familial adenomatous polyposis (FAP) necessitates colectomy and J-pouch ileanal anastomosis.
    • J-pouch surgery creates an ileal reservoir for fecal diversion after colon removal.

    Observation:

    • A 34-year-old male with a history of FAP presented with severe abdominal pain.
    • Imaging revealed free air and fluid, indicating intra-abdominal complications.
    • Laparotomy identified a 2-mm perforation at the blind end of the J-pouch.

    Findings:

    • Primary repair of the J-pouch perforation and a protective ileostomy were performed.
    • Postoperative endoscopy revealed pouchitis but no obstruction or stasis.
    • The patient recovered and was discharged on postoperative day 20.

    Implications:

    • This case highlights the potential for J-pouch perforation in FAP patients.
    • Prompt surgical intervention and ileostomy are crucial for managing such complications.
    • Long-term endoscopic surveillance is important for monitoring pouch health post-repair.