Home   Chapter Home   Jobs   Conferences   Fellowships   Books


Small bowel (small intestine)

Inflammatory disorders

Ileal pouch / pouchitis

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 15 December 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.


● Pouch is formed from connecting loops of terminal ileum for patients requiring total colectomy; used to create continence in an ileostomy or to preserve anal sphincter function
● Pouches are contraindicated in Crohn’s disease, because they are associated with fistulas and abscess
Complications: fistula, obstruction, incontinence, leaks, pouchitis


● Incidence 8% to 46%
● Some cases are due to initially undiagnosed Crohn’s disease
● Nausea, vomiting, malaise, fever, cramping
● Increased ileal stool that is bloody, watery, foul smelling
● Often with altered bacteria


● Antibiotics, pouch excision

Micro description

● Decreased epithelial cell mucin, few/no lymphoid follicles
● Ulcers with granulation tissue, cryptitis, crypt abscesses and patchy neutrophils
● Rarely dysplasia
● CD10 staining confirms biopsy site - terminal ileum (CD10+) versus colon (CD10-), although negative staining also occurs in active enteritis (Mod Pathol 2011;24:1627)

Micro images

CMV pouchitis: biopsy of post-colectomy pouch in 38 year old man with ulcerative colitis (courtesy of Dr. Hanni Gulwani)

CD10 staining

End of Small bowel (small intestine) > Inflammatory disorders > Ileal pouch / pouchitis

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).