Mid Pouch Strictureplasty for Crohn's Disease after Ileal Pouch-Anal Anastomosis: An Alternative to Pouch Excision

Gregory M. Matzke, Ajaipal S. Kang, Eric J. Dozois, William J. Sandborn

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

A 33-year-old female developed an isolated stricture of the mid portion of her ileal pouch nine years after proctocolectomy and J-ileal pouch-anal anastomosis for ulcerative colitis. Repeated episodes of pouchitis and partial small-bowel obstruction led to pouchoscopy and pouchography, which demonstrated pouch inflammation and a long, tight, midpouch stricture. Her diagnosis was changed to Crohn's disease and she was treated with azathioprine, budesonide, and infliximab. Repeat pouchoscopy demonstrated mucosal healing but a persistent fibrotic stricture. Pouch reconstruction was performed with a midpouch strictureplasty alleviating her obstructive symptoms. One year after surgery, the patient has no clinical evidence of obstruction and repeat pouchography demonstrates a wider pouch lumen across the strictureplasty site. Strictureplasty is an alternative to pouch excision in the management of patients with Crohn's disease who have an isolated pouch stricture.

Original languageEnglish (US)
Pages (from-to)782-786
Number of pages5
JournalDiseases of the colon and rectum
Volume47
Issue number5
DOIs
StatePublished - May 1 2004

Keywords

  • Crohn's
  • IPAA
  • Pouch stricture
  • Strictureplasty
  • Surgical technique

ASJC Scopus subject areas

  • Gastroenterology

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