Raul Raposo de Medeiros

Superior mesenteric artery syndrome as a complication of ileal pouch-anal anastomosis : report of a case

PURPOSE: Duodenal compression by the superior mesenteric artery following total proctocolectomy and ileal pouch-anal anastomosis is a rare occurrence. Previous surgical treatment involved duodenal division. The aim of this report was to describe a case with such a complication and to discuss an operative alternative. METHODS: Case report. RESULTS: Mobilization of the duodenum from its retroperitoneal attachments, without transection and reanastomosis, allowed the free passage of gas through the duodenum and recovery for the patient. CONCLUSION: This case report suggests that a more conservative approach may be successful in managing this complication.

The two-chamber ileal pelvic reservoir--an alternative design.

A new ileal pouch design, combining an upper triplicate ileum with a lower duplicate ileum, is described. The physical characteristics of this two-chamber reservoir would lead to better functional results by delaying the filling time of the reservoir.