For a study, researchers sought to report how we manage pelvic sepsis in people who have had a re-do ileal pouch-anal anastomosis (re-do IPAA) surgery. The study looked at the outcomes of people who had successful management of pelvic sepsis and compared them to the outcomes of a group of people who did not have pelvic sepsis. Functional outcomes, restrictions, and quality-of-life scores were compared between the groups. A total of 25 patients out of the 110 in the study developed pelvic sepsis. Of those, 23 had pelvic sepsis before ileostomy closure and 2 after. There were 6 pouch failures due to pelvic sepsis in the study period, 79% of which were successfully treated. Treatment options included drainage of abscesses with radiology (7 patients), IV antibiotics alone (5 patients), drainage and mushroom catheter placement with radiology (1 patient), mushroom catheter placement (1 patient), and endoluminal vacuum-assisted closure (1 patient). There was no difference between the pelvic sepsis and no pelvic sepsis groups in terms of the number of bowel movements, urgency, incontinence, pad use, or seepage (P>0.05). However, there were some differences in lifestyle alterations, Cleveland Global Quality of Life scores, and happiness with the surgery results (P>0.05). Pelvic sepsis is common after re-do IPAA surgery; however, the management strategy varies depending on the location and size of the abscess/sinus. Their management strategy can lead to high pouch salvage rates if detected early.

Source: journals.lww.com/dcrjournal/Abstract/2022/08000/Management,_Functional_Outcomes,_and_Quality_of.12.aspx