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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 ...
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.
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]
The signs and symptoms are variable, and in up to 25% of patients there may be no symptoms. [3] The most common signs and symptoms are bleeding, which can vary from minor to severe, rectal prolapse and incomplete evacuation (35%-76% of cases). [4]
Women over 50 are six times more likely to develop rectal prolapse than men. It is rare in men over 45 and in women under 20. [ 21 ] When males are affected, they tend to be young and report significant bowel function symptoms, especially obstructed defecation , [ 5 ] or have a predisposing disorder (e.g., congenital anal atresia ). [ 10 ]
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]
Pouchitis is an umbrella term for inflammation of the ileal pouch, an artificial rectum surgically created out of ileum (the last section of the small intestine) in patients who have undergone a proctocolectomy or total colectomy (removal of the colon and rectum). [1]
Liquid stool may leak around a fecal impaction, possibly causing degrees of liquid fecal incontinence. This is usually termed encopresis or soiling in children, and fecal leakage, soiling or liquid fecal incontinence in adults. Anismus is usually treated with dietary adjustments, such as dietary fiber supplementation.