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Stomas
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
John R.T. Monson, Iain Andrew Hunter
This negates the need for a large appliance and the troublesome issues of leakage and soiling. The continent ileostomy is a derivation of the pouch devised by Nils Kock in 1969.143 It utilises an intra-abdominal reservoir constructed from a small bowel pouch with an intussuscepting nipple valve to provide catheter-controlled continence. In a similar manner to the ileo-anal pouch, patients who retain their pouch report great satisfaction. However, valve slippage rates are high (7%–25%), as is the need for revisional surgery (an average of three procedures per patient in the Cleveland Clinic series). Overall, long-term pouch excision rates are reported at 8%–44%. The use of the continent ileostomy has diminished with the evolution of the ileo-anal pouch and the most up-to-date reports on long-term results terminate with patients from 2002.160,185,186,243 The main indication in the era of ileo-anal reconstruction would be for a motivated patient following ileo-anal pouch failure. This is evidently a highly specialised procedure.
Gastrointestinal system
Published in Aida Lai, Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Familial adenomatous polyposis (FAP) Autosomal dominant disorderMutation of APC gene (adenomatous polyposis gene) of chromosome 5Symptoms: – rectal bleedingCharacteristic lesion: – hypertrophy of retinal pigment epithelium (fundoscopy finding)Investigations: – genetic testsManagement: – proctocolectomy and ileo-anal pouch
Targets for interventions for faecal incontinence in inflammatory bowel disease: a systematic review
Published in Scandinavian Journal of Gastroenterology, 2018
Hannah Proudfoot, Christine Norton, Micol Artom, Eve Didymus, Sylwia Kubasiewicz, Bernadette Khoshaba
A history of abdominal and anal surgery was associated with FI [2,18,22]. This included anal fistula [2,18], colorectal surgery, total/partial colectomy, previous colostomy, anal fissure, anal stretch, ileo-anal pouch, and small bowel surgery and bowel resections [2,22]. Others found non-significant associations between FI and previous surgeries including anal surgery [17], anal fistula and ileo-anal pouch surgery.