Ileal pouch-anal anastomosis (IPAA) or "J"-pouch as it is commonly referred to, is the treatment of choice in patients with medically refractory ulcerative colitis. IPAA can have infectious, inflammatory, and mechanical complications. Currently, there are no Food and Drug Administration-approved medical therapies for these complications. Surgery that may be eventually required can have significant morbidities due to the complexity of IPAA. Endoscopy is fast emerging as a leading modality of treatment for some of these pouch complications. Endoscopy in adjunct with medical treatment can help manage the majority of pouch-related disorders and improve the outcome.
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http://dx.doi.org/10.1055/s-0041-1740032 | DOI Listing |
Cureus
December 2024
Gastroenterology and Hepatology, Monmouth Medical Center, Long Branch, USA.
Lemmel syndrome involves a periampullary duodenal diverticulum (PAD), a pouch-like outpouching near the ampulla of Vater, compressing the common bile duct. We describe a case of severe abdominal pain in a patient who had a large periampullary diverticulum, managed with surgical intervention after an initial failed endoscopic retrograde cholangiopancreatography (ERCP). An elderly female patient in her early 90s arrived at the emergency department with severe cramping pain localized to the right upper quadrant of her abdomen, progressively intensifying over several weeks.
View Article and Find Full Text PDFMicroorganisms
December 2024
Gastroenterology and Endoscopy IRCCS, Ospedale San Raffaele, 20132 Milano, Italy.
Acute severe ulcerative colitis (ASUC) often requires surgical intervention, such as proctocolectomy with ileal pouch-anal anastomosis (IPAA). While IPAA improves patient outcomes, it can be associated with pouchitis, a common and debilitating complication characterized by inflammation of the pouch. The development of pouchitis is closely linked to dysbiosis-an imbalance in the gut microbiota.
View Article and Find Full Text PDFPediatr Surg Int
January 2025
Department of Pediatric Surgery, Cleveland Clinic Children's Hospital, 8950 Euclid Avenue, Mail Code R3, Cleveland, OH, 44106, USA.
Background: Long-gap esophageal atresia (LGEA) can complicate the management of esophageal atresia (EA) with or without a tracheoesophageal fistula (TEF). This series describes a short interval, staged, thoracoscopic internal traction approach for LGEA with distal TEF to manage complex anastomotic tension or an anatomically impossible esophageal anastomosis.
Methods: A retrospective review (2018-2024) was performed across four tertiary centers to identify patients with LGEA and distal TEF, managed with a staged, thoracoscopic internal traction approach.
J Gastrointest Surg
January 2025
Cleveland Clinic, Cleveland, Ohio Department of Colorectal Surgery. Electronic address:
Background: This study aims to report the experience over 40 years and outcomes of 5070 patients who underwent a pelvic pouch procedure.
Methods: A retrospective analysis of a prospectively maintained IPAA database- (1983 - 2022) was performed. Patients were stratified based on the diagnosis: ulcerative colitis (UC), indeterminate colitis (IC), familial adenomatous polyposis (FAP), inflammatory bowel disease-dysplasia, Crohn's colitis (CD), and others.
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.
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