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AJR 2005; 184:1843-1847
© American Roentgen Ray Society

Original Report

Crohn's Disease in the Ileal Pouch After Total Colectomy for Ulcerative Colitis: Findings on Pouch Enemas in Six Patients

Nicolaus A. Wagner-Bartak1, Marc S. Levine1, Stephen E. Rubesin1, Igor Laufer1, John L. Rombeau2 and Gary R. Lichtenstein3

1 Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.
2 Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA.
3 Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA.

OBJECTIVE. The purpose of this study was to describe our experience with six patients who developed Crohn's disease in the ileal pouch or distal ileum after a total proctocolectomy and ileal pouch-anal anastomosis for ulcerative colitis.

CONCLUSION. Pouch enemas showed characteristic findings of Crohn's disease, including nodularity, thickened folds, ulceration, cobblestoning, strictures, sinus tracks, and fistulas to the perianal region and vagina. It is important for radiologists to be aware of the findings of Crohn's disease in the ileal pouch and distal ileum on radiographic studies of the pouch after total proctocolectomy and ileal pouch-anal anastomosis for ulcerative colitis because of the implications for patient management.


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