Journal
AMERICAN JOURNAL OF ROENTGENOLOGY
Volume 217, Issue 2, Pages 347-357Publisher
AMER ROENTGEN RAY SOC
DOI: 10.2214/AJR.20.24031
Keywords
ileal pouch; ileal pouch complication; ileal pouch enema protocol; ileal pouch MRI protocol; J-pouch; MRI reporting template; water-soluble contrast enema reporting template
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Ileal pouch-anal anastomosis (IPAA) surgery is the standard treatment for ulcerative colitis and familial adenomatous polyposis, but is associated with various complications. This article proposes structured reporting templates for imaging evaluation of pouch dysfunction post IPAA surgery, emphasizing a systematic search approach.
Ileal pouch-anal anastomosis (IPAA) surgery is the reference standard surgical procedure for treatment of ulcerative colitis and most patients with familial adenomatous polyposis. This procedure allows preservation of fecal continence and gastrointestinal continuity. However, it is associated with a wide variety of complications, which often have nonspecific and overlapping clinical presentations, making imaging an important part of workup for pouch dysfunction. The purpose of this article is to propose structured reporting templates for MRI and water-soluble contrast enema (WSCE), based on our referral pouch center's experience, in patients who have undergone IPAA surgery. We review salient surgical technique, pouch anatomy, and imaging protocols, with an emphasis on a systematic search pattern for evaluation of ileal pouch complications using proposed structured reporting templates for MRI and WSCE.
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