Late sequelae of blind intestinal pouches

Five case histories are presented which point out the complications of side to side intestinal anastomosis. In these instances a blind pouch was the sole cause of a variety of clinical problems. The difficulties in establishing an early correct diagnosis are understandable but not necessarily acceptable. Although isolated case reports reach the literature, it is indeed likely that the increasing use of end to end anastomoses will relegate these pouches to the position of actuarial oddities. It must be remembered, however, that the lateral anastomoses employed years ago remain potentially dangerous and may be the causes of many bizarre and longstanding abdominal complaints. An awareness of the possibility of a pouch in a patient with a history of intestinal resection, particularly if operated on a decade or so ago, could lead to early surgical intervention and replacement of the lateral anastomosis with an end to end anastomosis.