title: Diagnosis and Clinical Management of Ruptured Ileocecal Pouches for Continent Cutaneous Urinary Diversion.
abstract: OBJECTIVE
  The study aimed to report on pouch ruptures in 5 patients with ileocecal reservoirs for continent cutaneous urinary diversion.
  
  
  METHODS
  Five male patients aged 48-89 were referred to our department between 2000 and 2016 with a ruptured ileocecal pouch 16-175 months postoperatively.
  
  
  RESULTS
  With an incidence of 0.95% in our series (5 ruptures in 529 pouch patients out of a pool of 1,182 radical cystectomies) a rupture of the ileocecal pouch is a rare but severe complication. In all the cases, the rupture was supported by the over-distension of the reservoir, while a traumatic self-catheterization was reported in 2 patients. The rupture occurred on the right lateral wall of the ileocecal pouch in 4 out of 5 cases and led to acute abdominal pain and inflammation. Pouchography was performed in all the patients and revealed a leakage in 4 of them. The rupture was verified intraoperatively in 1 patient. Open surgical exploration, drainage and repair were successfully performed in all 5 cases.
  
  
  CONCLUSIONS
  Early diagnosis and immediate intervention are mandatory in the cases of pouch rupture to manage this severe complication, which is often related to reduction in patient compliance. Consequently, it is essential to raise awareness of this potentially life-threatening complication in patients with ileocecal pouches.
authors: Department of Urology and Paediatric Urology, Julius Maximilians University Medical Centre of Würzburg and Comprehensive Cancer Center (CCC) Mainfranken, Würzburg, Germany.
authors: Charis
authors: C
authors: Kalogirou
authors: Arkadius
authors: A
authors: Kocot
authors: Philipp
authors: P
authors: Mulfinger
authors: Elena
authors: E
authors: Hartmann
authors: Markus
authors: M
authors: Krebs
authors: Daniel
authors: D
authors: Vergho
authors: Hubertus
authors: H
authors: Riedmiller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002432:Cecum / Q000601:surgery; D015653:Cystectomy / Q000379:methods*; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D012421:Rupture; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent / Q000009:adverse effects*; D013520:Urologic Surgical Procedures / Q000379:methods*