MANAGEMENT OF OBLITERATING STRICTURE AFTER COLOANAL ANASTOMOSIS

We present an unconventional approach to the management of a severe st ricture with complete luminal obliteration after a coloanal anastomosi s which was protected with a diverting loop ileostomy. The colonoscope was inserted in an antegrade fashion into the defunctionalized limb o f the loop ileostomy and advanced to the level of the stricture. Under colonoscopic vision, a Kelly clamp was carefully introduced transanal ly through the stricture into the proximal lumen. The strictured anast omosis was then dilated with calibrated Hegar dilators. Periodic dilat ations followed by closure of the ileostomy completed the management. The technique obviated the need for a more extensive surgical procedur e.