J-pouch procedure - Crohn disease

Case contributed by Dr Bruno Di Muzio

Presentation

Abdominal pain. Known to the gastroenterology clinic.

Patient Data

Age: 40 years
Gender: Male
X-ray

Abdomen and pelvis

Small bowel gaseous dilatation and signs of extensive likely bowel surgery in the pelvis. No evidence of gas in the large bowel (procto-colectomy?). No pneumoperitoneum. 

CT

Abdomen and pelvis

Features of proctocolectomy with ileal pouch-anal anastomosis (IPAA) and a short segment of active ileal inflammation with stricture in its afferent loop. Engorged vasa recta. No signs of penetrating disease. The bowel is otherwise unremarkable. 

Case Discussion

This patient has a known history of Crohn's disease and has had proctocolectomy with ileal pouch-anal anastomosis many years ago (J-pouch surgery). Features are those of active Crohn's information with stricture. 

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Case information

rID: 78548
Published: 9th Jul 2020
Last edited: 9th Jul 2020
Inclusion in quiz mode: Included

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