Utility of Contrast Enema for Detecting Anastomotic Strictures After Total Proctocolectomy and Ileal Pouch–Anal Anastomosis

OBJECTIVE. The purpose of our study was to determine the utility of contrast enemas for detecting clinically relevant anastomotic strictures after total proctocolectomy and ileal pouch–anal anastomosis and to facilitate management by defining a critical anastomotic caliber at or below which obstruction is likely to develop after ileostomy closure.MATERIALS AND METHODS. Our radiology database revealed 42 patients with contrast enemas after total proctocolectomy and ileal pouch–anal anastomosis who fulfilled our exclusion criteria. The initial postoperative contrast enemas were reviewed blindly to determine the diameter of the ileoanal anastomosis. The diagnosis of a stricture was made only if the patient had signs of intestinal obstruction after ileostomy closure with confirmation on follow-up contrast enema or sigmoidoscopy and clinical improvement after anastomotic dilatation. The data were then correlated to determine if there was a critical anastomotic caliber at or below which such strictures were lik...