Image-Guided Sharp Recanalization of a Benign J Pouch Anastomotic Occlusion Facilitates Surgical Repair

A 27-year-old mat with a 9-year history of ulcerative colitis who had undergone total proctocolectomy with construction of a continent pouch in 2008 presented 1 year later with occlusion of the ileal pouch anal anastomosis precluding ileostomy closure.. An attempt at surgical reconstruction at an outside hospital failed, and the patient was informed that he would: have a permanent stoma. A further attempt at blind Surgical recanalization of the occlusion risked sphincter damage and was deferred. In 2010, reconstruction was performed using a hybrid approach combining image-guided sharp recanalization of the occluded anastomosis with positioning of a large-diameter Foley balloon catheter across the recanalized segment, followed by immediate surgical revision of the I pouch. Ileostomy closure was performed 1 month later. Continence Was preserved. Surgical repair preceded by sharp recanalization with positioning of a balloon catheter across the occluding membrane may safely regain durable potency in a chronically occluded ileal pouch-anal anastomosis.