The ileoanal J pouch: radiographic evaluation.

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Abstract
Endorectal ileoanal pull-through offers an attractive alternative to proctocolectomy and ileostomy for patients with ulcerative colitis, Gardner syndrome and familial polyposis. A careful radiographic analysis of the ileum, ileal pouch and ileoanal anastomosis after ileoanal pull-through has not been reported. Thirty-two patients with ulcerative colitis. Gardner syndrome and familial polyposis underwent colectomy, mucosal proctectomy and endorectal ileoanal pull-through of a 15-cm ileal "J" pouch and loop ileostomy. Twenty-five (78%) of 32 of all the pouches radiographically demonstrated spiral folds extending from the middle of the pouch to the pectinate line. Other radiographic features included a mesenteric mass effect, pseudopolyps and a central lucency that indicated intrapouch sutures. Radiographs provide useful information in the postoperative management of the ileal pull-through.