{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T16:36:48Z","timestamp":1776184608203,"version":"3.50.1"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T00:00:00Z","timestamp":1696550400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Approximately 1 in 10 patients with an ileal pouch\u2013anal anastomosis is diagnosed with Crohn\u2019s disease of the pouch (CDP). However, this diagnosis may be established inappropriately, as alternative underlying causes necessitating an alternative treatment approach, such as long-term surgical sequelae, may mimic CDP. In this study, we aimed to identify patients diagnosed with and treated for CDP with a (concurrent) alternative diagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Ulcerative colitis and inflammatory bowel disease unclassified patients who underwent ileal pouch\u2013anal anastomosis surgery in a tertiary center between 1990 and 2017 were retrospectively reviewed. Patients with a postoperative diagnosis of CDP for which medical treatment was initiated were identified. Presence of pouchitis, prepouch ileitis, stricture, and fistulas was assessed and histopathological reports were evaluated. Thereafter, cross-sectional images of the pouch in CDP patients were re-evaluated to identify potential long-term surgical sequelae (ie, chronic presacral sinus or perianastomotic fistulas).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>After a median postoperative follow-up of 6.2 (interquartile range, 2.3-13.5) years, 47 (10%) of 481 patients were diagnosed with CDP. CDP patients had pouchitis (n\u2005=\u200538 [81%]), prepouch ileitis (n\u2005=\u200534 [74%]), strictures (n\u2005=\u200517 [36%]), fistulas (n\u2005=\u200515 [32%]), or a combination. Multiple granulomas were found in 1 pouch resection specimen. Re-evaluation of 40 (85%) patients who underwent magnetic resonance imaging revealed presence of long-term surgical sequelae in 17 (43%) patients. Six (15%) patients demonstrated isolated nonanastomotic fistulas.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Re-evaluation of cross-sectional imaging of the pouch revealed that potential alternative causes were found in nearly half of CDP patients. Cross-sectional imaging is therefore recommended early in the diagnostic pathway to exclude an alternative diagnosis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ibd\/izad228","type":"journal-article","created":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T20:49:36Z","timestamp":1696625376000},"page":"1635-1641","source":"Crossref","is-referenced-by-count":9,"title":["Crohn\u2019s Disease of the Ileoanal Pouch: A High Rate of Potential Overdiagnoses"],"prefix":"10.1093","volume":"30","author":[{"given":"Maud","family":"Reijntjes","sequence":"first","affiliation":[{"name":"Department of Surgery , Amsterdam , Amsterdam ,","place":["the Netherlands"]},{"name":"University Medical Center , Amsterdam , Amsterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2522-9798","authenticated-orcid":false,"given":"Djuna","family":"de Jong","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology , Amsterdam , Amsterdam ,","place":["the Netherlands"]},{"name":"University Medical Center , Amsterdam , Amsterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elise","family":"Wessels","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology , Amsterdam , Amsterdam ,","place":["the Netherlands"]},{"name":"University Medical Center , Amsterdam , Amsterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rogier","family":"Goetgebuer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology , Amsterdam , Amsterdam ,","place":["the Netherlands"]},{"name":"University Medical Center , Amsterdam , Amsterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Willem","family":"Bemelman","sequence":"additional","affiliation":[{"name":"Department of Surgery , Amsterdam , Amsterdam ,","place":["the Netherlands"]},{"name":"University Medical Center , Amsterdam , Amsterdam ,","place":["the Netherlands"]},{"name":"Department of Gastroenterology and Hepatology, Radboud University Medical Center , Nijmegen ,","place":["the Netherlands"]},{"name":"IBD Unit, San Raffaele University Hospital , Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cyriel","family":"Ponsioen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology , Amsterdam , Amsterdam ,","place":["the Netherlands"]},{"name":"University Medical Center , Amsterdam , Amsterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geert","family":"D\u2019Haens","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology , Amsterdam , Amsterdam ,","place":["the Netherlands"]},{"name":"University Medical Center , Amsterdam , Amsterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roel","family":"Hompes","sequence":"additional","affiliation":[{"name":"Department of Surgery , Amsterdam , Amsterdam ,","place":["the Netherlands"]},{"name":"University Medical Center , Amsterdam , Amsterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christianne","family":"Buskens","sequence":"additional","affiliation":[{"name":"Department of Surgery , Amsterdam , Amsterdam ,","place":["the Netherlands"]},{"name":"University Medical Center , Amsterdam , Amsterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marjolijn","family":"Duijvestein","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology , Amsterdam , Amsterdam ,","place":["the Netherlands"]},{"name":"University Medical Center , Amsterdam , Amsterdam ,","place":["the Netherlands"]},{"name":"Department of Gastroenterology and Hepatology, Radboud University Medical Center , Nijmegen ,","place":["the Netherlands"]},{"name":"IBD Unit, San Raffaele University Hospital , Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,10,6]]},"reference":[{"issue":"9","key":"2024100305534924600_CIT0001","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1093\/ibd\/izz005","article-title":"The incidence and definition of Crohn\u2019s disease of the pouch: a systematic review and meta-analysis","volume":"25","author":"Barnes","year":"2019","journal-title":"Inflamm Bowel Dis."},{"issue":"5","key":"2024100305534924600_CIT0002","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1093\/ibd\/izy020","article-title":"Management of pouchitis and other common complications of the pouch","volume":"24","author":"Dalal","year":"2018","journal-title":"Inflamm Bowel Dis."},{"issue":"6","key":"2024100305534924600_CIT0003","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1097\/MIB.0000000000000712","article-title":"Crohn\u2019s disease of the ileoanal pouch","volume":"22","author":"Lightner","year":"2016","journal-title":"Inflamm Bowel Dis."},{"issue":"2","key":"2024100305534924600_CIT0004","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1002\/ibd.20661","article-title":"Crohn\u2019s disease of the ileal pouch: reality, diagnosis, and management","volume":"15","author":"Shen","year":"2009","journal-title":"Inflamm Bowel Dis."},{"issue":"5","key":"2024100305534924600_CIT0005","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1007\/s11894-012-0282-4","article-title":"Diagnosis and differential diagnosis of Crohn\u2019s disease of the ileal pouch","volume":"14","author":"Li","year":"2012","journal-title":"Curr Gastroenterol 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diagnosis","volume":"248","author":"Melton","year":"2008","journal-title":"Ann Surg."},{"issue":"4","key":"2024100305534924600_CIT0009","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/s10151-022-02688-9","article-title":"Classification of surgical causes of and approaches to the chronically failing ileoanal pouch","volume":"27","author":"Meima-van Praag","year":"2022","journal-title":"Tech Coloproctol."},{"issue":"4","key":"2024100305534924600_CIT0010","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1097\/DCR.0000000000001285","article-title":"Abnormal pouchogram predicts pouch failure even in asymptomatic patients","volume":"62","author":"Sossenheimer","year":"2019","journal-title":"Dis Colon Rectum."},{"issue":"12","key":"2024100305534924600_CIT0011","doi-asserted-by":"crossref","first-page":"1967","DOI":"10.1007\/DCR.0b013e3181b77d1e","article-title":"Outcome of salvage surgery for ileal pouches referred with a diagnosis of Crohn\u2019s 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