An unusual cause of anal pain following ileal pouch-anal anastomosis

Ileal pouch-anal anastomosis (IPAA) is a safe and effective operation in properly selected patients, but a variety of potential complications can occur. We present a case of a 56-year-old female who underwent a double-stapled IPAA for refractory ulcerative colitis and postoperatively developed unrelenting, severe anal pain requiring daily narcotics. Examination under anesthesia revealed that her pain was a result of staples from the anastomosis that had migrated into the highly sensitive anoderm below the dentate line. Removal of these staples led to resolution of her symptoms.