Diagnosis and management of floppy pouch complex

Gastroenterol Rep (Oxf). 2018 Nov;6(4):246-256. doi: 10.1093/gastro/goy021. Epub 2018 Jul 3.

Abstract

Restorative proctocolectomy with ileal pouch-anal anastomosis has become the surgical treatment of choice for patients with refractory ulcerative colitis, colitis-associated dysplasia or familial adenomatous polyposis. There are various pouch disorders and associated complications. Floppy pouch complex is defined as the presence of pouch prolapse, afferent limb syndrome, enterocele, redundant loop and folding pouch on pouchoscopy, gastrografin pouchogram or defecography. Common clinical presentation includes dyschezia, bloating, abdominal pain, straining or the sense of incomplete evacuation. Each disorder has its own unique endoscopic, radiographic and manometry findings. A range of therapeutic options are available for the management of the various causes of a pouch.

Keywords: Floppy pouch complex; afferent limb syndrome; efferent limb syndrome; ileal pouch; prolapse; ulcerative colitis.

Publication types

  • Review