title: Successful endoscopic needle knife therapy combined with topical doxycycline injection of chronic sinus at ileal pouch-anal anastomosis.
abstract: OBJECTIVE
  Chronic presacral sinus at the anastomosis after restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA) has been difficult to manage and results in a high rate of pouch failure. The aim was to present a novel technique with a combining endoscopic doxycycline injection and needle knife therapy for a sinus at the ileoanal anastomosis.
  
  
  METHODS
  We applied repeat Doppler ultrasound-guided endoscopic needle knife therapy to open the orifice of the anastomotic sinus followed by topical injection of doxycycline.
  
  
  RESULTS
  After six sessions of the endoscopic therapy, the refractory sinus was completely healed.
  
  
  CONCLUSIONS
  The Doppler ultrasound guided endoscopy therapy may provide an alternative treatment option for the patients with anastomotic sinus.
authors.affiliation: Department of Gastroenterology, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.forename: B
authors.initials: B
authors.lastname: Shen
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000175:diagnosis / Q000628:therapy*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D039021:Colonic Pouches / Q000473:pathology; D003131:Combined Modality Therapy; D004318:Doxycycline / Q000627:therapeutic use*; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D008297:Male; D016737:Proctocolectomy, Restorative; D012445:Sacrococcygeal Region
chemical_list: D000900:Anti-Bacterial Agents; D004318:Doxycycline