KOCK POUCH DYSFUNCTION DURING PREGNANCY - MANAGEMENT OF A CASE

The Kock continent ileostomy is a surgical alternative to a Brooke ile ostomy after total proctocolectomy. Complications resulting from an im properly functioning nipple valve are not infrequent and when they occ ur most often require surgical revision. A 19-year-old female with a f unctioning Kock pouch of 4 years presented at 6 months of pregnancy wi th complete bowel obstruction due to nipple valve dysfunction. Operati ve management was avoided and her bowel obstruction was relieved by en doscopic placement of a stent through the nipple valve and into the ab dominal reservoir. The stent was removed at 1 week postpartum with imm ediate return to normal function of her Kock pouch nipple valve. Tempo rary malfunction of the Kock pouch nipple valve can occur during pregn ancy, probably due to distortion of the valve mechanism by the enlargi ng uterus. The endoscopic placement of a stent can maintain proper bow el evacuation until delivery and normal Kock pouch function can be exp ected after stent removal.