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Hyperbaric oxygen therapy for chronic antibioticrefractory ischemic pouchitis

Gastroenterology Report 2017年第4期5卷 320-321,I0003页

作者： custon t.nyabanga Geeta Kulkarni Bo Shen Cleveland Clinic Lerner College of Medicine of Case Western Reserve University ClevelandOHUSA Department of Gastroenterology/Hepatology Cleveland ClinicClevelandOHUSA

Hyperbaric oxygen therapy(HBOt)has been shown to be efficacious in treating various conditions,including perianal Crohn’s *** we present a case of a 59-year-old male with a history of ulcerative colitis,who underwent a total proctocolectomy and two-stage J-pouch *** later developed chronic antibiotic-refractory pouchitis with endoscopic features of *** the completion of HOBt-a total of 20 sessions of 100%oxygen at 2.5-3.0 atmospheres absolute for 60-90 minutes per session-a repeat pouchoscopy showed marked improvement of endoscopic mucosal *** is known to increase tissue oxygenation,reduce tissue hypoxia,alter inflammatory pathways and promote tissue *** case demonstrated the therapeutic role of HBOt as well as the possible disease mechanism in chronic antibiotic-refractory pouchitis.

关键词： hyperbaric oxygen therapy refractory pouchitis ischemic pouchitis

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Computed tomography-guided endoscopic needle knife therapy for ileal pouch sinus

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Gastroenterology Report 2016年第4期4卷 334-336,I0003页

作者： custon t.nyabanga Joseph Veniero Bo Shen Cleveland Clinic Lerner College of Medicine of Case Western Reserve University ClevelandOHUSA Department of Diagnostic Radiology Cleveland ClinicClevelandOHUSA Center for Inflammatory Bowel Diseases Digestive Disease InstituteCleveland ClinicClevelandOHUSA

Ileal pouch-anal anastomosis surgery can be complicated by anastomotic leaks,leading to the formation of abscess and chronic sinus that have been routinely managed by a surgical *** developed the endoscopic needle knife sinusotomy(NKSi)technique,which has become a valid *** basic principle of endoscopic NKSi is dissection and drainage of the sinus through its orifice internally into the lumen of pouch *** success of NKSi requires an access to the sinus from the pouch *** of the most challenging situations for NKSi is a closed orifice of the sinus,which leaves an isolated chronic abscess *** we report a case of complicated presacral sinus with a closed orifice that was not amenable to NKSi,necessitating a Ct-guided guide wire placement and subsequent NKSi.

关键词： endoscopic needle knife sinusotomy ileal pouch-anal anastomosis anastomotic leak presacral sinus computed tomography

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