Following a radical cystectomy and the creation of a Kock pouch, a filling defect developed in the renal pelvis that appeared to be a transitional cell carcinoma. This appearance was produced by the retrograde migration and implantation of a fragment of suture material used in the creation of the pouch. It represents a previously undescribed complication of this procedure.
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Approach to Therapy for Chronic Pouchitis.
Annu Rev Med
January 2025
Department of Medicine, University of California San Diego, La Jolla, California, USA.
Chronic pouchitis (CP) occurs in approximately 20% of patients with ulcerative colitis after total proctocolectomy with ileal pouch anal anastomosis and is categorized as antibiotic dependent, antibiotic refractory, or Crohn's disease-like. The management of CP is challenging because of limited evidence and few randomized controlled trials. In this review, we discuss the medical management of CP and its supporting data delineated by type of therapy.
View Article and Find Full Text PDFIleal pouch-anal anastomosis for ulcerative colitis: 30-year analysis on surgical evolution and patient outcome.
BJS Open
December 2024
Department of Abdominal Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
Background: Proctocolectomy with ileal pouch-anal anastomosis is the treatment of choice for patients with ulcerative colitis with medical refractory disease or dysplasia. The aim of this research was to describe the evolution of ileal pouch-anal anastomosis surgery and surgical outcomes over a three-decade interval in a high-volume referral centre.
Methods: All consecutive patients undergoing ileal pouch-anal anastomosis for ulcerative colitis between 1990 and 2022 at the University Hospitals of Leuven were retrospectively included.
Multiomic analysis reveals cellular, transcriptomic and epigenetic changes in intestinal pouches of ulcerative colitis patients.
Nat Commun
January 2025
University of Chicago, Department of Medicine, Chicago, IL, USA.
Total proctocolectomy with ileal pouch anal anastomosis is the standard of care for patients with severe ulcerative colitis. We generated a cell-type-resolved transcriptional and epigenetic atlas of ileal pouches using scRNA-seq and scATAC-seq data from paired biopsy samples of the ileal pouch and the ileal segment above the pouch (pre-pouch) from patients (male=4, female=2), and paired biopsies of the terminal ileum and ascending colon from healthy individuals (male=3, female=3) serving as reference. Our study finds an additional population of absorptive and secretory epithelial cells within the pouch but not the pre-pouch.
View Article and Find Full Text PDFAn ileo-anal pouch doing the twist (with video).
Clin Res Hepatol Gastroenterol
January 2025
Centre for Digestive Endoscopy, APHP, Saint Antoine Hospital, Sorbonne University, Paris, France. Electronic address:
A 37-year-old female patient had a past history of proctocolectomy for Crohn's disease, with ileal J-pouch-anal anastomosis. She was admitted for acute obstructive symptoms. CT scan revealed a 180 twisted ileo-anal anastomosis without signs of severe ischemia (Fig.
View Article and Find Full Text PDFGastrointestinal symptoms related to COVID-19 in ileoanal pouch and stoma patients.
Br J Nurs
December 2024
Nurse Practitioner, Pouch and Stoma Care, TWINS for iPouch & Stoma Patients Ltd.
COVID-19 symptoms are often perceived as respiratory only. However, recent findings have shown that gastrointestinal symptoms are being reported in a significant number of patients, ranging from 17% to more than 50%, with some studies speculating that the figure may be even higher, but that it is under-reported and overlooked. Therefore, a hypothesis was put forward that gastrointestinal symptoms related to COVID-19 may make pouch or stoma function deteriorate or even mimic pouchitis symptoms in ileoanal pouches and gastroenteritis in stoma patients; the intention was to investigate this further and to test the hypothesis.
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