| Cuffitis | |
|---|---|
 | |
| Different regions of Ileal pouch-anal anastomosis | |
| Specialty | General surgery |
Cuffitis is inflammation at the anal transition zone or "cuff" created as a result of ileal pouch-anal anastomosis (IPAA). [1] It is considered a variant form of ulcerative colitis that occurs in the rectal cuff. [2] Cuffitis is a common complication of IPAA, particularly when a stapled anastomosis without mucosectomy procedure has been used. [2]
Symptoms of cuffitis mimic those of pouchitis. [2] In addition, patients with cuffitis often present with small volume bloody bowel movements. [2] Often, cuffitis can produce the appearance of bright red blood on tissue. [1]
Surgery-associated ischemia may contribute inflammation at the anal transitional zone. [2]
Patients whose cuffitis is refractory to mesalamine and/or corticosteroids should be evaluated for other disease in the cuff area, such as fistula or anastomotic leaks. [2] Cuffitis that is refractory to medication can also be a sign of Crohn's disease of the pouch. [2]
Chronic cuffitis can also contribute to the development of anastomotic stricture. [2]
Cuffitis that is refractory, Crohn's-related, or is associated with surgical complications can contribute to pouch failure. [2]
Definitive diagnose of cuffitis is obtained by endoscopy. [2]
Cuffitis is treated with mesalamine suppositories or topical application of lidocaine or corticosteroid medications. [2] Systemic medications are rarely used. [2]