Yeah, fistulas can wreak all sorts of havoc, where ever they are. There are many, many failed j-pouches that had perfectly good pouches, but the fistula made them fail functionally. Sometimes they can salvage, sometimes not. But, I guess with the continent ileo pouch, there is more room for creativity, just like sometimes they can salvage a j-pouch and make it a k-pouch!
I guess Dr. Deitz is the new heir apparent for Dr. Remzi these days?