Clinical features and management of afferent limb syndrome after ileal pouch-anal anastomosis for ulcerative colitis

Yoshiki Okita, Toshimitsu Araki, Mikio Kawamura, Satoru Kondo, Mikihiro Inoue, Minako Kobayashi, Yuji Toiyama, Masaki Ohi, Koji Tanaka, Yasuhiro Inoue, Keiichi Uchida, Yasuhiko Mohri, Masato Kusunoki

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Purpose: Afferent limb syndrome (ALS) is a type of small bowel obstruction (SBO) caused by obstruction of the afferent intestinal limb after ileal pouch-anal anastomosis (IPAA). The aim of this study was to reveal the clinical features and management of ALS. Methods: Of 320 patients undergoing IPAA for ulcerative colitis, we analyzed data from patients presenting with SBO. Results: Six of 19 patients with SBO were diagnosed with ALS. All patients with ALS presented with recurrent intermittent obstructive symptoms before admission, whereas 15 % of patients without ALS presented with these symptoms (P < 0.0005). Among the six patients with ALS, four patients required surgery, although they underwent transanal decompression for each episode of obstruction. The proportion of surgery was higher in the ALS group (P < 0.01). Acute angulation of the afferent limb was recognized in four cases and followed by fixation of the afferent limb. No further surgery was required in any patient following the last fixation. Conclusions: SBO after IPAA may be caused by acute angulation of the afferent limb of the ileal J-pouch. Most patients with ALS may eventually require fixation of the afferent limb due to acute angulation of the afferent limb.

Original languageEnglish
Pages (from-to)1159-1165
Number of pages7
JournalSurgery Today
Volume46
Issue number10
DOIs
Publication statusPublished - 01-10-2016
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery

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