Radiology, Vol 155, 591-594, Copyright © 1985 by Radiological Society of North America
The ileoanal J pouch: radiographic evaluation
AE Hillard, FA Mann, JM Becker and JA Nelson
Endorectal ileoanal pull-through offers an attractive alternative to
proctocolectomy and ileostomy for patients with ulcerative colitis, Gardner
syndrome, and familial polyposis. To our knowledge, 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.
