Endoscopic balloon dilation in pre-pouch ileal strictures in patients with Crohn's-like disease of the pouch - A tool not to be overlooked!

Strictures are among the possible complications of ileal pouch-anal anastomosis (IPAA) performed after restorative proctocolectomy for ulcerative colitis (UC) and occur in approximately 11% of patients following this surgical procedure. Large-scale data for EBD in pouch strictures worldwide are still lacking, especially for pouch strictures in the context of Crohn's disease (CD)-like disease of the pouch. We report a procedural success in treating, through EBD, a complex case of double short pouch stenosis in an elderly patient with coexisting CD-like pouch disorder and chronic antibiotic-refractory pouchitis. The patient, a 78-year-old female, was diagnosed with UC (E3 according to Montreal classification) in 2009 and, due to the development of severe disease activity, underwent a two-step restorative proctocolectomy with the construction of a J-pouch IPAA (2001).