J pouch

Imaging findings, surgical variations, natural history, and common complications

Joshua D. Reber, John M. Barlow, Amy Lightner, Shannon P. Sheedy, David H. Bruining, Christine O. Menias, Joel Garland Fletcher

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Ileal pouch–anal anastomosis, or J pouch, surgery has become the procedure of choice for treatment of medically refractory ulcerative colitis and familial adenomatous polyposis. Overall, this operation is associated with a low rate of postoperative morbidity and good long-term function. However, when complications develop, there is a heavy reliance on imaging to facilitate an accurate diagnosis. Reported postoperative complication rates range from 5% to 35%. Complications generally can be categorized as structural, inflammatory, or neoplastic conditions. Structural complications include leaks, strictures, afferent and efferent limb syndromes, and pouch prolapse. Inflammatory conditions include cuffitis, pouchitis, and Crohn disease of the pouch. In addition, a variety of neoplastic conditions can develop in the pouch. Overall, pouchitis and leaks are the most common complications, occurring in up to 50% and 20% of individuals, respectively. Many imaging modalities are used to evaluate the J pouch and associated postoperative complications. The indications and various surgical techniques for J pouch surgery, normal postoperative appearance of the pouch, and most common associated complications are reviewed. In addition, the various imaging findings associated with J pouch surgery are described and illustrated. The radiologist’s familiarity with the potential complications of the pouch can facilitate appropriate imaging, hasten an accurate diagnosis, and aid in rendering proper management.

Original languageEnglish (US)
Pages (from-to)1073-1088
Number of pages16
JournalRadiographics
Volume38
Issue number4
DOIs
StatePublished - Jul 1 2018

Fingerprint

Colonic Pouches
Natural History
Pouchitis
Adenomatous Polyposis Coli
Prolapse
Ulcerative Colitis
Crohn Disease
Pathologic Constriction
Extremities
Morbidity
Therapeutics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Reber, J. D., Barlow, J. M., Lightner, A., Sheedy, S. P., Bruining, D. H., Menias, C. O., & Fletcher, J. G. (2018). J pouch: Imaging findings, surgical variations, natural history, and common complications. Radiographics, 38(4), 1073-1088. https://doi.org/10.1148/rg.2018170113

J pouch : Imaging findings, surgical variations, natural history, and common complications. / Reber, Joshua D.; Barlow, John M.; Lightner, Amy; Sheedy, Shannon P.; Bruining, David H.; Menias, Christine O.; Fletcher, Joel Garland.

In: Radiographics, Vol. 38, No. 4, 01.07.2018, p. 1073-1088.

Research output: Contribution to journalArticle

Reber, JD, Barlow, JM, Lightner, A, Sheedy, SP, Bruining, DH, Menias, CO & Fletcher, JG 2018, 'J pouch: Imaging findings, surgical variations, natural history, and common complications', Radiographics, vol. 38, no. 4, pp. 1073-1088. https://doi.org/10.1148/rg.2018170113
Reber JD, Barlow JM, Lightner A, Sheedy SP, Bruining DH, Menias CO et al. J pouch: Imaging findings, surgical variations, natural history, and common complications. Radiographics. 2018 Jul 1;38(4):1073-1088. https://doi.org/10.1148/rg.2018170113
Reber, Joshua D. ; Barlow, John M. ; Lightner, Amy ; Sheedy, Shannon P. ; Bruining, David H. ; Menias, Christine O. ; Fletcher, Joel Garland. / J pouch : Imaging findings, surgical variations, natural history, and common complications. In: Radiographics. 2018 ; Vol. 38, No. 4. pp. 1073-1088.
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