I had step 1 8/07, obstruction surgery 9/07, takedown 11/07, surgery to drain abscesses 12/19/07, and j-pouch disconnected & new temp ileostomy 12/26/07(due to leak in j-pouch). I have had a J-P drain in since the surgery, and am still on antibiotics.

I saw my surgeon yesterday. He thinks the leak is down where the pouch is stapled to the rectal cuff. I have been off prednisone for over a month and he thinks the leak should have healed by now, if it was going to do so on its own.

He gave me 3 options -- 1)wait another month, 2)remove j-pouch & go to permanent ileostomy, or 3)let him scope pouch under general anesthesia & perhaps put in a atitch or two if he can find the leak. He does not have much experience fixing leaks in j-pouches.

I don't like any of these options. 1) I have a horrid yeast rash under the wafer; I also think I'm allergic to the Convatec adhesive; part of the incision opened & I have to pack it so I have to trim the wafer; my belly is very bumpy after 5 operations in 4 months; & so my wafer fails 3 nights out of 4. Also I have had this drain in for over 2 months already.

2) I only had the j-pouch working for about 6 weeks. I would like to try it again before going to permanent ileo. Also skin problems with wafers make me think I would be miserable with permanent ileo.

3) I worry about possible incontinence issues or strictures since my surgeon has not done a lot of these repairs. He tried to find the leak during the last 2 surgeries, but could not. The radiologist sees contrast leaking from the pouch on the CAT scans.

Should I try to get a second opinion from Dr. Fazio, or some expert? Does anyone know of a surgeon in North Carolina who is experienced in j-pouch repairs?

Thanks for any help.

This message has been edited. Last edited by: TAL,

I would absolutly see someone experienced with pouches! You don't sound ready to give up on the pouch, I don't know whats close enough to you, when I had mine, my GI gave the choice of Cleveland Clinic, Mayo or University . There is a post on here of best surgeons, try looking at that list. Best Wishes to you !
LoriP

If it were me, I would find a second opinion and would probably seek out the best (Mayo or Cleveland Clinic).

I read your post and am so sorry to hear about all of your problems. If it were me, I would be ready for something (anything!) to work right for once. Good luck!

Thanks, LoriP and ElmerFudd.

Dr. Fazio at Cleveland Clinic is on medical leave until May, so we were referred to Dr. Remzi. Anyone know anything about him, or any of the other surgeons at Cleveland Clinic?

I saw a post that tedrock saw Dr. Remzi, you could try to PM him?
LoriP

Get thee to the Cleveland Clinic!!!! I had Dr. Remzi for my surgeries and all I can say is wonderful things about him. He is tops in all areas. Several people here had him as their surgeon and feel the same. http://cms.clevelandclinic.org/digestivedisease/body.cf...action=detail&ref=18

Thanks! My surgeon is going to talk to Dr. Remzi about a referral.