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DOI: 10.1055/a-0840-3262
Wire-guided stricturotomy for sealed ileal pouch
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Publication History
Publication Date:
12 February 2019 (online)
A 31-year-old woman with a 10-year history of ulcerative colitis was seen at our outpatient clinic with complaint of abdominal pain and increased output from her ileostomy. She had previously undergone a subtotal colectomy with an end ileostomy for medically refractory ulcerative colitis in 2008. She then underwent elective complete proctectomy with ileal pouch-anal anastomosis and diverting loop ileostomy 6 months later. We decided to perform pouchoscopy to rule out pouch-related complications ([Video 1]).
Video 1 Wire-guided stricturotomy for sealed ileal pouch.
Quality:
Illeoscopy was performed via the stoma. The terminal ileum appeared normal to 25 cm from stoma. The patient was found to have a diverted pouch outlet stricture. The sealed outlet was detected by a Jagwire (Boston Scientific, Marlborough, Massachusetts, USA) ([Fig. 1 a, b]). We then performed knife stricturotomy over the guidewire ([Fig. 1 c, d]). Moderate diversion pouchitis with exudates was noted. We were able to pass the scope without difficulty ([Fig. 1 e]).


The patient tolerated the procedure well without any immediate complications. She reported improvement in her symptoms at the 1-month follow-up visit.
Sealed ileal pouch can be safely and effectively treated with wire-guided endoscopic stricturotomy.
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Competing interests
None
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