Ileoanal pouch

The ileoanal pouch is an invasive surgical procedure that creates a side-to-end anastomosis between the end section of the ileum and the anus. In this surgical procedure, an artificial stool reservoir ("pouch") is created from the last section of the small intestine.

An ileoanal pouche is created as an alternative to an enterostoma (artificial bowel outlet) and serves to maintain the patient's continence. The pouch allows the bowel to be emptied more slowly. The intestinal contents can accumulate in the enlarged small intestine. In most cases this is a J-pouch, more rarely a W-, S- or lateral pouch.

Pouch-associated septic complications occur in 10% of all restorative proctocolectomies with ileoanal pouching in ulcerative colitis. In a larger study (n=130 patients), 5 anastomosis insufficiencies, 3 pouch leaks (one patient had a combined leak), 3 peripouchal abscesses, 1 pouchanal fistula and 1 pouchvaginal fistula were found. The absence of a protective loop ileostomy was a risk factor for a pouch-associated septic complication (Mennigen R et al. 2011).

Further complications are pouchitis and irritable pouch syndrome.

1. Mennigen R et al (2011) Septic pouch-associated complications after proctocolectomy in ulcerative colitis: Good function and quality of life after successful pouch preservation. Z Gastroenterol 49 - P276