Abstract
Ileal pouch-anal anastomosis (IPAA) is the standard restorative procedure after proctocolectomy in patients with ulcerative colitis who require colectomy for their diseases. Due to the significant anatomic alterations induced by surgery, ileal pouch is susceptible to a variety of insults including mechanic, ischemia, fecal stasis, infectious agents, the development of idiopathic inflammatory pouch disease, and the recurrence of underlying inflammatory bowel disease (IBD). In addition, neoplasia may arise from ileal pouch. Although clinical, endoscopic, and radiographic examinations diagnose many ileal pouch diseases, histologic examination still plays an essential role in the diagnosis and management of these diseases, particularly in antibiotic-refractory chronic pouchitis and pouch neoplasia. Our knowledge of pouch diseases has been greatly expanded in recent years and it forms the basis of this chapter.
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