TWISTED POUCH SYNDROME: NEW SOLUTIONS TO A DIAGNOSTIC DILEMMA?
Tracy L. Hull, Stefan D. Holubar*
Colon and Rectal Surgery, Cleveland Clinic, Cleveland, OH
We previously defined Twisted Pouch Syndrome (TPS) as a triad of symptoms including 1) erratic bowel habits with urgency/frequency, 2) abdominal/pelvic/rectal pain, often severe (suggestive of ischemia) and requiring opioids, and 3) obstructive symptoms including small bowel obstruction and/or obstructive defecation (Holubar, Gastroenterology, 160(3), S22-S23, 2021). In this video, we present 1) a video clip demonstrating TPS during open surgery, 2) intra-operative video of diagnostic laparoscopy for TPS, and 3) a novel radiographic method for detecting TPS using CT-scan 3D segmentation of staple-line morphology.
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