To understand anatomic and radiologic features of proctocolectomy with Ileal Pouch-Anal AnastomosisIleal Pouch-Anal Anastomosis (IPAA)performed in patients with Ulcerative Colitis (UC).
To review complications derived from surgery and its underlying disease registered in our tertiary hospital.
Restorative total proctocolectomy with IPAAis the gold-standard surgical procedure in patients with UC, UC with dysplasia, and for patients with Familial Adenomatous Polyposis (FAP).
Less commonly, the procedure is performed to treat hereditary non-polyposis colorectal cancer or toxic megacolon.
The surgery involves the creation of an ileal reservoir or pouch which is anastomosed to the anal canal preserving gastrointestinal continuity and the anal sphincter complex to maintain fecal continence.
There are various techniques for the creation of the reservoir pouch, but theJ-shaped configuration...
Findings and procedure details
A numerous illustrative fluoroscopic enemas and cross-sectional imaging studies (CT and MRI)performed at our institution are analyzed in order to describe the normal pouch radiological featuresas well as its complications.
Several classifications have been described to refer complications of IPAA.[2,12] In this review we classify them based on time of appearance in earlyor delayed.
Radiologists must be familiar with the IPAA surgical technique and the postoperative anatomy to identify and characterize complications seen at CT, MRI and fluoroscopy, in order to hasten an accurate diagnose and guide clinical and therapeutic decision-making.
Personal information and conflict of interest
A. Antón Jiménez; Barcelona/ES - nothing to disclose D. Armario Bel; Barcelona/ES - nothing to disclose M. J. Moreno; Madrid/ES - nothing to disclose E. A. Moraru; Barcelona/ES - nothing to disclose J. Salvador Civil; Barcelona/ES - nothing to disclose M. Martí-Gallostra; Barcelona/ES - nothing to disclose R. Mast; Hospitalet de Llobregat/ES - nothing to disclose X. Merino Casabiel; Barcelona, BARCELONA/ES - nothing to disclose
Sheedy S.P., Bartlett D.J., Lightner A.L. Judging the J pouch: A pictorial review. Abdom Radiol 218; 44 (3): 845-866.
Reber J.D., Barlow J.M., Lightner A.L. J Pouch: Imaging findings, surgical variations, natural history and common complications. RadioGraphics 2018; 38: 1073-1088.
Seggerman R.E., CHen M.Y., Waters G.S. Pictorial Essay. Radiology of Ileal Pouch-Anal Anastomosis Surgery. AJR 2003; 180(4): 999-1002.
Lovegrove RE, Constantinides VA, Heriot AG, et al. A comparison of hand-sewn versus stapled ileal pouch anal anastomosis (IPAA) following proctocolectomy: a meta-analysis of 4183 patients. Ann...