Restorative proctocolectomy: morphological and functional study with coronal CT.
BACKGROUND
Restorative proctocolectomy with ileal pouch has become the surgical treatment of choice for patients with ulcerative colitis (UC) and familial polyposis of the colon. Defecography is the radiological technique commonly employed to obtain detailed information on function and morphology of the ileal pouch; it allows the direct visualization of the ileal pouch and the anal canal, but it does not provide the visualization of the pelvis.


METHODS
In all patients, computed tomography (CT) on coronal planes was performed to determine its possibilities as an alternative to defecography; 10 patients with UC submitted to restorative proctocolectomy and were examined.


RESULTS
Coronal CT images provided a panoramic vision of the pelvis and demonstrated the morphology of the ileal pouch, the thickness of its walls, and its correlation with the surrounding tissues. Coronal CT also allowed the evaluation of the continence of ileo-anal and ileo-ileal anastomosis and the functional changes of the perineal muscles at rest and during squeezing.


CONCLUSIONS
CT images acquired on coronal planes allows an easy and clear detection of the major postoperative complications, such as stenosis or dehiscences of the anastomosis, pelvic phlogosis, and fistulae.
Pizzamiglio
M
M
Department of Radiology, University of Rome "La Sapienza," Policlinico Umberto I, V.le Regina Elena 324, 00161 Rome, Italy.
Catalano
C
C
Sarrantonio
A
A
Pavone
P
P
Pronio
A
A
Montesani
C
C
Ribotta
G
G
Passariello
R
R
D011125:Adenomatous Polyposis Coli / Q000601:surgery; D000328:Adult; D001003:Anal Canal / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D000714:Anastomosis, Surgical; D003093:Colitis, Ulcerative / Q000601:surgery; D003672:Defecation; D005260:Female; D006801:Humans; D007082:Ileum / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D007249:Inflammation; D007412:Intestinal Fistula / Q000000981:diagnostic imaging; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D010388:Pelvis / Q000000981:diagnostic imaging; D010502:Perineum / Q000503:physiopathology; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D016737:Proctocolectomy, Restorative; D013529:Surgical Wound Dehiscence / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed