Most common post operative complication of ileo anal pouch anastomosis in ulcerative colitis is:
Correct Answer: Pouchitis
Description: Ans is 'a' i.e. Pouchitis "Pouchitis occurs in nearly 50% of patients, and small bowel obstruction is not uncommon."- Schwaz 9/e Maingot's 11/e lists results of a meta-analysis of over 8,300 patients from 18 major studies showing the major complications and outcomes after ileal pouch-anal anastomosis. According to this meta analysis: Most common complication is---- Pouchitis Next most common is--------------- Small bowel obstruction In Beal Pouch Anal Anastomosis (Restorative Proctocolectomy) the entire colon and rectum are resected, but the anal sphincter muscles and a variable poion of the distal anal canal are preserved. Bowel continuity is restored by anastomosis of an ileal reservoir to the anal canal. The neorectum is made by anastomosis of the terminal ileum aligned in a "J," "S," or "W" configuration. Most common configuration used is the "J" configuration as it is the simplest to construct and functional outcomes are similar in all. (Ref: Schwaz 9/e p1027) Indications are conditions where colectomy is to be done such as Ulcerative colitis, FAP, Gardner's syndrome, hereditary nonpolyposis colon cancer. Complications: Sho-term complications or those that occur within 30 days of surgery include pelvic sepsis and abscesses primarily due to anastomotic or pouch leakage. Long-term complications include increased bowel movements (average 6 per day), small bowel obstruction, anastomotic strictures, fistulas, sexual dysfunction, pouchitis, and adhesions.
Category:
Surgery
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