UMMS Affiliation

Department of Surgery

Publication Date


Document Type



Digestive System | Digestive System Diseases | Gastroenterology | Pathological Conditions, Signs and Symptoms | Surgery | Surgical Procedures, Operative


Total proctocolectomy with ileal pouch-anal anastomosis can restore gastrointestinal continuity in patients requiring colectomy for ulcerative colitis, however, it can be associated with high morbidity. Reoperation for pouch-related complications is technically challenging and often leads to deterioration of pouch function or need for permanent stoma. We report a case of acute on chronic small bowel obstruction secondary to a 360-degree twist in the small bowel introduced during creation of the ileal-anal pouch. Our novel approach at repair has not been reported in past literature which included resection and re-anastomosis of the small bowel proximal to the pouch allowing for pouch salvage with return to function.


small bowel obstruction, colectomy, ulcerative colitis, anastomosis, surgical, intestine, repeat surgery, stomas, surgical procedures, ileoanal anastomosis, anus, ileum, morbidity, proctocolectomy

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© The Author(s) 2018. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact

DOI of Published Version



J Surg Case Rep. 2018 Jun 15;2018(6):rjy133. doi: 10.1093/jscr/rjy133. eCollection 2018 Jun. Link to article on publisher's site

Journal/Book/Conference Title

Journal of surgical case reports

Related Resources

Link to Article in PubMed

PubMed ID


Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License