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Management of ileal pouch prolapse with endoscopic hot snare / Tratamento de prolapso da bolsa ileal com alca diatermica endoscopica
Wu, Xian-rui; Liu, Xiu-li; Lan, Nan; Shen, Bo.
  • Wu, Xian-rui; Cleveland Clinic Foundation. Department of Colorectal Surgery. Cleveland. US
  • Liu, Xiu-li; Cleveland Clinic Foundation. Department of Colorectal Surgery. Cleveland. US
  • Lan, Nan; Cleveland Clinic Foundation. Department of Gastroenterology/Hepatology. Cleveland. US
  • Shen, Bo; Cleveland Clinic Foundation. Department of Gastroenterology/Hepatology. Cleveland. US
J. coloproctol. (Rio J., Impr.) ; 33(2): 92-94, April-June/2013. ilus
Article in English | LILACS | ID: lil-683215
ABSTRACT
Pouch prolapse is a complication following the creation of restorative proctocolectomy. There is a paucity of information in the literature pertaining to its management. An ileal J pouch patient with dyschezia presented to our Pouch Center. Under sedation, pouchoscopy was performed with a gastroscope. We detected an anterior distal pouch mucosal prolapse, 1.5 cm in diameter, blocking the anal canal. The prolapsed mucosa was excised with hot snare under a retroflex view. There was no bleeding or perforation. The entire procedure took 25 minutes. The patient tolerated the procedure well and was discharged home 30 minutes after post-procedural observation. The patient reported the resolution of the dyschezia symptom. The histopathological examination of excised specimen showed small bowel mucosa and sub-mucosa with changes compatible with mucosal prolapse. Endoscopic hot snare appears to be feasible in the management of pouch mucosal prolapse. (AU)
RESUMO
O prolapso da bolsa ileal é uma complicação que pode surgir após a criação da proctocolectomia restauradora. As informações na literatura são escassas quanto ao tratamento. Um paciente com bolsa ileal em "J" e apresentando disquezia deu entrada em nosso centro médico. Sob sedação, realizamos uma endoscopia da bolsa ileal. Detectamos uma bolsa distal anterior com prolapso da mucosa, com 1,5 cm de diâmetro, bloqueando o canal anal. O prolapso da mucosa foi retirado com alça diatérmica sob visão retroflexa. Não houve sangramento ou perfuração. A duração de todo o processo foi de 25 minutos. O paciente tolerou bem o procedimento e recebeu alta após 30 minutos de observação pós-procedimento. O paciente relatou a resolução do sintoma de disquezia. O exame histopatológico do espécime extirpado mostrou a mucosa e submucosa do intestino delgado com alterações compatíveis com o prolapso da mucosa. A alça diatérmica endoscópica parece ser viável no tratamento de prolapso da mucosa da bolsa ileal. (AU)
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Prolapse / Colonic Pouches Limits: Humans / Male Language: English Journal: J. coloproctol. (Rio J., Impr.) Journal subject: Cirurgia / Doen‡as Retais / Doen‡as do Colo / Gastroenterology / Cirurgia Year: 2013 Type: Article Affiliation country: United States Institution/Affiliation country: Cleveland Clinic Foundation/US

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Full text: Available Index: LILACS (Americas) Main subject: Prolapse / Colonic Pouches Limits: Humans / Male Language: English Journal: J. coloproctol. (Rio J., Impr.) Journal subject: Cirurgia / Doen‡as Retais / Doen‡as do Colo / Gastroenterology / Cirurgia Year: 2013 Type: Article Affiliation country: United States Institution/Affiliation country: Cleveland Clinic Foundation/US