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                    <span style="font-weight: bold; ">Long-axis rotational volvulus in an ileal J-pouch anal anastomosis: A preventable rare complication</span> <span id="JournalInfor_reviewpaper_show" style="color:gray;Display:None;">()</span>
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                    <a href='articles.aspx?searchcode=Virgilio+V.++George&searchfield=authors&page=1' target='_blank'>Virgilio V.  George</a>, <a href='articles.aspx?searchcode=Alyssa++Fajardo&searchfield=authors&page=1' target='_blank'>Alyssa  Fajardo</a> 

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                        Affiliation(s)</a>
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                    <a href='articles.aspx?searchcode=Department+of+Surgery%2c+Indiana+University+School+of+Medicine%2c+Indianap-olis%2c+Indiana&searchfield=affs&page=1&skid=0' target='_blank'>Department of Surgery, Indiana University School of Medicine, Indianap-olis, Indiana</a>.<br />
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	<span style="font-size:10.0pt;font-family:;" "=""><span style="font-family:Verdana;">Puropose: This study
was designed to report a very rare long-term complication of ileal-Jpouch
anal anastomosis: An 180 degree longaxial rotational volvulus causing J pouch
obstruction. Methods: An Ovid and Medline search using the following keywords
was performed: J pouch ileoanal anastomosis, J-pouch ileoanal anastomosis
complications, J-pouch volvulus, J-pouch complications, restorative proctocolectomy
complications, and restorative proctocolectomy volvulus. One J-pouch ileoanal
anastomosis 180<span style="font-family:Verdana, Helvetica, Arial;white-space:normal;background-color:#FFFFFF;">°</span> volvulus report was found [1]. Result: We describe a long-axis
180<span style="font-family:Verdana, Helvetica, Arial;white-space:normal;background-color:#FFFFFF;">°</span> rotational volvulus complication of a J-pouch ileoanal anastomosis. The J
pouch was performed three years prior after the laparoscopic total proctocolectomy
for chronic ulcerative colitis. Pouch excision and new ileoanal J-pouch surgery
were then performed along with pexy using alloderm mesh placement with
excellent outcomes. Conclusion: Long-axis 180<span style="font-family:Verdana, Helvetica, Arial;white-space:normal;background-color:#FFFFFF;">°</span> rotational volvulus is a rare
complication of a J-pouch ileoanal anastomosis. Pouch dysfunction after a
long-axis rotational volvulus is an uncommon cause of acute abdomen. Lack of
adhesions and pouch </span><span style="font-family:Verdana;">size are risk factors
for the pouch torsion. Prompt </span><span style="font-family:Verdana;">diagnosis and treatment are essential for the
pouch salvage. Simple abdominal x-ray, barium enema and CT scan represent
important tools for diagnosis. Salvage surgery should be performed even if
detorsion and decompression of the affected bowel are achieved. Surgery has </span><span style="font-family:Verdana;">excellent outcomes if performed after the prompt</span><span style="font-family:Verdana;"> diagnosis. Pouch pexy should be done to prevent recurrent volvulus.</span></span> 
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                    KEYWORDS
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                <div align="justify">
                    <a href='articles.aspx?searchcode=Ileal+Pouch%3b+Ileal+Anal+Anastomosis%3b+Malrotation&searchfield=keyword&page=1&skid=0' target='_blank'>Ileal Pouch; Ileal Anal Anastomosis; Malrotation</a> 
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                    Cite this paper
                </p>
                <div align="justify">
                    George, V.  and Fajardo, A.   (2014) Long-axis rotational volvulus in an ileal J-pouch anal anastomosis: A preventable rare complication. <i>Case Reports in Clinical Medicine</i>, <b>3</b>, 28-31. doi: <a href='http://dx.doi.org/10.4236/crcm.2014.31007' target='_blank' onclick='SetNum(42231)'>10.4236/crcm.2014.31007</a>.
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                <p style="font-size: 14px; font-weight: bold;">Conflicts of Interest</p>
                <p style="text-align: justify;">
                    The authors declare no conflicts of interest.</p>
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