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In medicine, the ileal pouch–anal anastomosis (IPAA), also known as restorative proctocolectomy (RPC), ileal-anal reservoir (IAR), an ileo-anal pouch, ileal-anal pullthrough, or sometimes referred to as a J-pouch, S-pouch, W-pouch, or a pelvic pouch, is an anastomosis of a reservoir pouch made from ileum (small intestine) to the anus, bypassing the former site of the colon in cases where the ...
Cuffitis is inflammation at the anal transition zone or "cuff" created as a result of ileal pouch-anal anastomosis (IPAA). [1] It is considered a variant form of ulcerative colitis that occurs in the rectal cuff. [2] Cuffitis is a common complication of IPAA, particularly when a stapled anastomosis without mucosectomy procedure has been used. [2]
An anastomotic leak is a fault in the surgical connection between the two remaining sections of bowel after a resection is performed. This allows the bowel contents to leak into the abdomen. Anastomotic leaks may cause infection, abscess development, and organ failure if untreated. Surgical steps are taken to prevent leaks when possible.
An anastomosis carries the risk of dehiscence or breakdown of the surgical connection. Contamination of the peritoneal cavity with fecal matter as a result of the anastomotic leak can lead to peritonitis, sepsis or death. In patients who underwent colectomy as a treatment for colorectal cancer, an anastomotic leak increases the risk of ...
This procedure requires a temporary loop ileostomy to allow the anastomosis to heal. With lifestyle adjustments, those who have had this procedure for their Crohn's disease can resume normal bowel movements without artificial appliances. However, there is always the possibility of disease relapse, as Crohn's can affect mouth to anus. [13]
Symptoms include abdominal pain which may come and go, vomiting, abdominal bloating, and bloody stool. [1] It often results in a small bowel obstruction. [1] Other complications may include peritonitis or bowel perforation. [1] The cause in children is typically unknown; in adults a lead point is sometimes present. [1]
A variety of mechanisms can be the cause of pouchitis including inflammatory factors such as a dysbiosis sparked inflammation or Crohn's disease of the pouch, surgical causes including surgical join leaks and pelvic sepsis, or infectious from Clostridioides difficile (C Diff) or Cytomegalovirus (CMV). It is possible to have more than one factor ...
Diagrammatically, the Roux-en-Y anastomosis looks a little like the letter Y. [ citation needed ] Typically, the two upper limbs of the Y represent (1) the proximal segment of stomach and the distal small bowel it joins with and (2) the blind end that is surgically divided off, and the lower part of the Y is formed by the distal small bowel ...