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UNTWISTING THE PLOT: RESOLVING A MISDIAGNOSIS OF CROHN'S DISEASE IN AN ULCERATIVE COLITIS PATIENT WITH A TWISTED J-POUCH
Kamil Erozkan, Imran Khan^*, Faris S. Almadi, Tracy Hull, Olga Lavryk
Colorectal Surgery, Cleveland Clinic, Cleveland, OH

Patients with UC are often candidates for proctectomy with IPAA, but they remain at risk for pouch-related complications, including pouch failure. One such complication, pouch twisting, can clinically mimic Crohn’s disease. Detailed clinical examination and advanced imaging are essential for accurate diagnosis. We present a case of a 48-year-old woman with a history of UC who underwent a total proctocolectomy with IPAA, and was later treated for misdiagnosed CD, which was, in fact, a twisted pouch. This case highlights the critical importance of thorough diagnostic evaluation in patients with suspected pouch complications. Misdiagnosis can lead to unnecessary and ineffective interventions.

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