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Traumatic perforation of ileal pouch. Report of a case

T C Hsu1

  • 1Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan.

Diseases of the Colon and Rectum
|January 1, 1989
PubMed

Insights

A rare case of ileal pouch perforation after restorative proctocolectomy is presented. Prompt diagnosis and surgical intervention led to a successful outcome, highlighting the importance of considering pouch complications in ulcerative colitis patients.

Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology
  • Abdominal Surgery

Background:

  • Restorative proctocolectomy is increasingly performed for ulcerative colitis and polyposis coli.
  • Ileal pouch-anal anastomosis (IPAA) is a common surgical procedure for these conditions.
  • Complications of IPAA can be serious and require prompt recognition.

Observation:

  • A 28-year-old female with a history of ulcerative colitis and IPAA presented with acute abdominal pain.
  • Initial diagnosis was perforated peptic ulcer, but history revealed recent abdominal trauma.
  • Laparotomy identified a perforation in the afferent limb of the ileal pouch.

Findings:

  • The ileal pouch perforation was successfully managed with debridement and primary closure.
  • Temporary decompression of the pouch was performed.
  • The patient experienced a good outcome following the surgical intervention.

Implications:

  • Ileal pouch perforation should be considered in patients with a history of IPAA presenting with signs of a perforated viscus.
  • Early diagnosis and appropriate surgical management can preserve the ileal pouch.
  • This case highlights a rare but significant complication of restorative proctocolectomy.

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