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The ileoanal J pouch: radiographic evaluation
Radiology
|June 1, 1985
Summary
Endorectal ileoanal pull-through surgery for ulcerative colitis and polyposis shows distinct spiral folds on radiographs. These findings aid in the postoperative management of ileal pouches and ileoanal anastomosis.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Radiology
Background:
- Endorectal ileoanal pull-through is an alternative to proctocolectomy and ileostomy for specific conditions.
- Radiographic analysis of the ileum, ileal pouch, and anastomosis after this procedure is not well-documented.
Purpose of the Study:
- To report the radiographic findings after endorectal ileoanal pull-through.
- To describe the characteristic radiographic features of the ileal J-pouch and anastomosis.
Main Methods:
- Thirty-two patients with ulcerative colitis, Gardner syndrome, or familial polyposis underwent colectomy, mucosal proctectomy, and endorectal ileoanal pull-through.
- A 15-cm ileal "J" pouch and loop ileostomy were created.
- Radiographic analysis of the ileal pouch and anastomosis was performed.
Main Results:
- Spiral folds extending from the middle of the pouch to the pectinate line were observed in 78% of pouches.
- Other findings included mesenteric mass effect, pseudopolyps, and central lucency indicating sutures.
Conclusions:
- Radiographic features, particularly spiral folds, are common after endorectal ileoanal pull-through.
- Radiographs are valuable for postoperative management of patients undergoing ileal pull-through procedures.