title: Volvulus of ileal S-pouch: A rare complication of ileal pouch anal anastomoses.
abstract: BACKGROUND
  Ileal pouch anal anastomosis (IPAA) after total proctocolectomy is a frequently performed surgery for medically refractory ulcerative colitis (UC). Volvulus of the ileal pouch as a complication of IPAA is extremely rare. We present a case of volvulus of S-type ileal pouch.
  
  
  METHODS
  A 28 year old male, with history of total proctocolectomy with IPAA for severe UC in 2009 presented with signs of bowel obstruction. Emergency laparotomy was done and a volvulus of the S-type ileal pouch was derotated and pouchpexy done.
  
  
  CONCLUSIONS
  The IPAA has a wide spectrum of complications, with obstruction of proximal small bowel occurring frequently. Volvulus of the ileal pouch is extremely rare with only 3 reported cases. Early diagnosis and intervention is important to salvage the pouch. Computed tomography (CT) may aid the diagnosis in stable patients.
  
  
  CONCLUSIONS
  The diagnosis of ileal pouch volvulus although rare, should be kept in mind when dealing with patients complaining of recurrent obstruction following IPAA.
authors.affiliation: Department of General Surgery, S.M.S. Medical College, JLN Marg, Jaipur 302004, Rajasthan, India. Electronic address: gauravtyagi6886@gmail.com.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Tyagi
authors.affiliation: Department of General Surgery, S.M.S. Medical College, JLN Marg, Jaipur 302004, Rajasthan, India. Electronic address: drutsav86@gmail.com.
authors.forename: Utsav
authors.initials: U
authors.lastname: Gupta
authors.affiliation: Department of General Surgery, S.M.S. Medical College, JLN Marg, Jaipur 302004, Rajasthan, India. Electronic address: ankit.doc2004@gmail.com.
authors.forename: Ankit
authors.initials: A
authors.lastname: Verma
authors.affiliation: Department of General Surgery, S.M.S. Medical College, JLN Marg, Jaipur 302004, Rajasthan, India. Electronic address: dr.dhananjaysaxena@gmail.com.
authors.forename: Dhananjay
authors.initials: D
authors.lastname: Saxena
authors.affiliation: Department of General Surgery, S.M.S. Medical College, JLN Marg, Jaipur 302004, Rajasthan, India. Electronic address: a.mittal007@gmail.com.
authors.forename: Atul
authors.initials: A
authors.lastname: Mittal
authors.affiliation: Department of General Surgery, S.M.S. Medical College, JLN Marg, Jaipur 302004, Rajasthan, India. Electronic address: amitgoyal0304@gmail.com.
authors.forename: Amit
authors.initials: A
authors.lastname: Goyal
authors.affiliation: Department of General Surgery, S.M.S. Medical College, JLN Marg, Jaipur 302004, Rajasthan, India. Electronic address: jeevan.kankaria@gmail.com.
authors.forename: Jeevan
authors.initials: J
authors.lastname: Kankaria
authors.affiliation: Department of General Surgery, S.M.S. Medical College, JLN Marg, Jaipur 302004, Rajasthan, India. Electronic address: jenawrk@yahoo.com.
authors.forename: R K
authors.initials: RK
authors.lastname: Jenaw
keywords: IPAA; Ileal S-pouch; Ileal pouch volvulus; Pouchpexy; Volvulus