They compared CT, indium-11 (In-111) scintigraphy, and fluoroscopic pouchography for the detection of pouchitis, abscess, and fistula. For pouchitis, the sensitivity of CT, In-111 scintigraphy, and pouchography was 71%, 80%, and 53%, respectively. To our knowledge, there is no recent literature evaluating and comparing scintigraphy for the diagnosis of proctitis or pouchitis. There is no relevant recent literature regarding the use of Tc-99m white blood cell (WBC) scan in the evaluation of suspected proctitis or pouchitis. Anorectal Disease prolapse in the case of IPAA. A meta-analysis of complications after total proctocolectomy with IPAA performed by Hueting et al [59] showed a pooled incidence of 9.5% for pelvic sepsis, 5.5% for pouch-related anal or vaginal fistula, 9.2% for strictures, and 13.1% for small-bowel obstruction. The initial imaging modality for patients with a suspected postoperative complication may vary based upon the suspected complication. CT is often the first imaging modality used for patients who return following surgery with acute pain, sepsis, or signs of bowel obstruction. CT Abdomen and Pelvis CT abdomen and pelvis may be preferred over CT pelvis alone, depending upon the clinical scenario or specific type of operation performed. To our knowledge, there are no studies comparing noncontrast CT to IV contrast- enhanced CT for the detection of postoperative complications. However, IV contrast does improve the detection of abscesses and is important for the evaluation of the integrity of the bowel wall when ischemia or anastomotic dehiscence is suspected. CT with and without contrast would only be indicated when there is benefit from dual- phase imaging. When anastomotic leak is suspected, rectally administered contrast material is important to demonstrate extraluminal extravasation of contrast to confirm the leak, adding an additional finding to other findings of leak: perianastomotic gas, fluid collection, and staple line integrity.
Anorectal Disease. They compared CT, indium-11 (In-111) scintigraphy, and fluoroscopic pouchography for the detection of pouchitis, abscess, and fistula. For pouchitis, the sensitivity of CT, In-111 scintigraphy, and pouchography was 71%, 80%, and 53%, respectively. To our knowledge, there is no recent literature evaluating and comparing scintigraphy for the diagnosis of proctitis or pouchitis. There is no relevant recent literature regarding the use of Tc-99m white blood cell (WBC) scan in the evaluation of suspected proctitis or pouchitis. Anorectal Disease prolapse in the case of IPAA. A meta-analysis of complications after total proctocolectomy with IPAA performed by Hueting et al [59] showed a pooled incidence of 9.5% for pelvic sepsis, 5.5% for pouch-related anal or vaginal fistula, 9.2% for strictures, and 13.1% for small-bowel obstruction. The initial imaging modality for patients with a suspected postoperative complication may vary based upon the suspected complication. CT is often the first imaging modality used for patients who return following surgery with acute pain, sepsis, or signs of bowel obstruction. CT Abdomen and Pelvis CT abdomen and pelvis may be preferred over CT pelvis alone, depending upon the clinical scenario or specific type of operation performed. To our knowledge, there are no studies comparing noncontrast CT to IV contrast- enhanced CT for the detection of postoperative complications. However, IV contrast does improve the detection of abscesses and is important for the evaluation of the integrity of the bowel wall when ischemia or anastomotic dehiscence is suspected. CT with and without contrast would only be indicated when there is benefit from dual- phase imaging. When anastomotic leak is suspected, rectally administered contrast material is important to demonstrate extraluminal extravasation of contrast to confirm the leak, adding an additional finding to other findings of leak: perianastomotic gas, fluid collection, and staple line integrity.