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The patient was considered to have pouch outlet obstruction and was successfully managed using bedside evacuation anoscopy. After 3days, oral nutrition was re-established, and appropriate stool evacuation and fecal continence were achieved. Proctocolectomy with ileal pouch-anal anastomosis still carries a considerable complication rate. Proper identification of causative factors is mandatory for appropriate treatment. Pouch outlet obstruction can present as acute abdomen after diverting ileostomy closure. In this case, outlet obstruction
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