Related Experiment Video
Updated: Jul 26, 2025
08:49
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
16.5K
Recurrent Pouch Volvulus Following Ileoanal J-Pouch Anastomosis: A Case Report
Mohammad Alabdulrahman1, Lea Stuart1, Ellie Smith1
1School of Medicine, Royal College of Surgeons in Ireland, Dublin, IRL.
Cureus
|June 19, 2023
Summary
Recurrent pouch volvulus, a rare complication of ulcerative colitis surgery, can necessitate multiple interventions. This case highlights the challenges and eventual management with a permanent ileostomy for refractory cases.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Colorectal Surgery
Background:
- Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the standard surgical treatment for severe refractory ulcerative colitis (UC).
- While generally safe, IPAA surgery can lead to complications such as anastomotic leaks, abscesses, and the rare occurrence of pouch volvulus.
Observation:
- A 57-year-old female with a history of refractory UC, who previously underwent IPAA surgery without immediate complications, presented 15 years later with recurrent obstructive symptoms.
- Initial exploratory laparotomy revealed no adhesions or necrosis, but subsequent investigations confirmed recurrent pouch volvulus.
Findings:
- The patient underwent multiple endoscopic decompressions and an enteropexy for the recurrent pouch volvulus.
- Despite interventions, the volvulus recurred, leading to the decision for a permanent loop ileostomy for definitive management.
Implications:
- This case underscores the rarity and challenging management of recurrent pouch volvulus following IPAA surgery.
- It highlights the potential need for surgical revision or diversion, such as a permanent ileostomy, in refractory cases.
- Further research into preventative strategies and management of recurrent pouch volvulus is warranted.
Related Concept Videos
01:21Inflammatory Bowel Disease V: Surgical Management
174
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
174
01:28Esophageal Perforation-II: Clinical Manifestations and Management
96
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
96
01:29Appendicitis-II: Diagnostic Studies and Management
104
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
104
01:26Esophageal Strictures-II: Clinical Features and Management
112
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
112
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
128
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
128
01:22Esophageal Perforation-I: Introduction
133
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
133