Crohn's Disease in the Ileal Pouch After Total Colectomy for Ulcerative Colitis: Findings on Pouch Enemas in Six Patients

OBJECTIVE: The purpose of this study was to describe our experience with six patients who developed Crohn's disease in the ileal pouch or distal ileum after a total proctocolectomy and ileal pouch-anal anastomosis for ulcerative colitis. CONCLUSION: Pouch enemas showed characteristic findings of Crohn's disease, including nodularity, thickened folds, ulceration, cobblestoning, strictures, sinus tracks, and fistulas to the perianal region and vagina. It is important for radiologists to be aware of the findings of Crohn's disease in the ileal pouch and distal ileum on radiographic studies of the pouch after total proctocolectomy and ileal pouch-anal anastomosis for ulcerative colitis because of the implications for patient management.