Treatment of outflow tract problems associated with continent ileostomy (Kock pouch). Report of six cases.
The Kock pouch procedure has undergone a number of revisions since its conception, including creation of a valve and fascial stabilization. Nevertheless, complications which defeat the goal of continence are not unheard of. Naturally, when such complications arise, the patients are disadvantaged. Major examples include pouchitis and valve leakage. Lesser complications of strictures of the outflow tract, valve prolapse, and tissue loss in the outflow tract are also identified and are surgically remediable. Problems may be successfully addressed by minor corrections under local anesthesia or may mandate more extensive procedures. Examples are provided of such successful cases, which allow patients to derive the benefits of continent ileostomy.
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
L M
LM
Gottlieb
J C
JC
Handelsman
D003251:Constriction, Pathologic / Q000209:etiology; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D006801:Humans; D007082:Ileum / Q000473:pathology* / Q000601:surgery; D008297:Male; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*; D011391:Prolapse