Was looking through my old files and stumbled on a list I made a while back while doing my research of possible K-Pouch Complications. I'm sure I may have missed some, so please add on to it and it's management. Best -Mark
- Early Complications – parastomal hernia, parastomal fistula, nipple valve necrosis, intestinal obstruction, and major bleeding from suture lines (dehiscence). Suture lines dehiscence and valve necrosis both require immediate surgical correction.
- Late Complications
- Slipped/Sliding Nipple Valve (Desusception) – stoma comes apart and returns to original state. Results in incontinence WITH intubation difficulties. Requires surgical correction.
- Nipple Valve Fistula – abnormal opening usually found at or near the base of the valve. Caused by technical problems of valve construction or trauma caused by frequent intubations. Results in incontinence WITHOUT difficulty in intubation. Requires surgical correction.
- Pouchitis – inflammation of the pouch mucosa. More often related to prolonged periods of intubation and bacterial overgrowth. May cause blood, fever, excessive diarrhea that can overwhelm the valve and cause incontinence. Requires broad-spectrum antibiotics.
- Nipple Valve Prolapse – caused by fascial defect, which is made to bring out the efferent loop, is too wide. Requires surgical correction.
- Stenosis – narrowing of the nipple valve caused by development of hypertrophic scars. Can be managed with a baby pacifier or if necessary a procedure called Z-plasty.
- Pouch Dislocation / Volvulus (twisting) of the pouch - caused by inadequate fixation of the pouch to the abdominal wall, causes intubation difficulties, requires surgical correction.
- Complete Bowel Obstruction – intubation difficulties, but pouch remains continent. Requires urgent medical assistance.
Resources
- https://books.google.com/books...function&f=false
- https://books.google.com/books...function&f=false
- https://books.google.com/books...problems&f=false
