RESTORATIVE PROCTOCOLECTOMY - MORPHOLOGICAL AND FUNCTIONAL-STUDY WITHCORONAL CT

Background: Restorative proctocolectomy with ileal pouch has become th e surgical treatment of choice for patients with ulcerative colitis (U C) and familial polyposis of the colon. Defecography is the radiologic al technique commonly employed to obtain detailed information on funct ion and morphology of the ileal pouch; it allows the direct visualizat ion of the ileal pouch and the anal canal, but it does not provide the visualization of the pelvis. Methods: In all patients, computed tomog raphy (CT) on coronal planes was performed to determine its possibilit ies as an alternative to defecography; 10 patients with UC submitted t o restorative proctocolectomy and were examined. Results: Coronal CT i mages provided a panoramic vision of the pelvis and demonstrated the m orphology of the ileal pouch, the thickness of its walls, and its corr elation with the surrounding tissues. Coronal CT also allowed the eval uation of the continence of ileo-anal and ileo-ileal anastomosis and t he functional changes of the perineal muscles at rest and during squee zing. Conclusion: 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 fist ulae.