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https://www.readbyqxmd.com/read/29337777/rescue-diverting-loop-ileostomy-an-alternative-to-emergent-colectomy-in-the-setting-of-severe-acute-refractory-ibd-colitis
#1
Tara A Russell, Aaron J Dawes, Danielle S Graham, Stephanie A K Angarita, Christina Ha, Jonathan Sack
BACKGROUND: Severe acute refractory colitis has traditionally been an indication for emergent colectomy in IBD, yet under these circumstances patients are at elevated risk for complications because of their heightened inflammatory state, nutritional deficiencies, and immunocompromised state. OBJECTIVE: We hypothesized that rescue diverting loop ileostomy may be a viable alternative to emergent colectomy, providing the opportunity for colonic healing and patient optimization before more definitive surgery...
February 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29337776/l%C3%A3-mann-index-at-diagnosis-predicts-the-risk-of-early-surgery-in-crohn-s-disease
#2
Wei Liu, Wei Zhou, Jianjian Xiang, Qian Cao, Jinzhou Zhu, Weilin Qi, Pengpeng Chen, Qingwen Xie
BACKGROUND: Identifying patients with Crohn's disease with rapid disease progress or high risk of early surgery is crucial to clinical decision making. OBJECTIVE: The aim was to evaluate the correlation between the Lémann index at diagnosis and abdominal surgery in the first year after Crohn's disease diagnosis and to find the risk factors for early surgery. DESIGN: This was a retrospective cohort study. SETTINGS: The study was conducted at a single tertiary hospital...
February 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29327167/does-laparoscopic-intracorporeal-ileocolic-anastomosis-decreases-surgical-site-infection-rate-a-propensity-score-matched-cohort-study
#3
L Martinek, K You, S Giuratrabocchetta, M Gachabayov, K Lee, R Bergamaschi
AIM: Foreshortened mesentery or thick abdominal wall constitutes a rationale for laparoscopic intracorporeal ileocolic anastomoses (ICA). The aim of this study was to compare intracorporeal to extracorporeal ICA in terms of surgical site infections in patients with Crohn's ileitis and overweight patients with right colon tumors. METHOD: This was a prospective propensity score-matched cohort study enrolling consecutive patients with Crohn's terminal ileitis and overweight patients with right colon tumors undergoing elective laparoscopic right colon resection with intracorporeal or extracorporeal ICA...
January 11, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29325789/long-term-outcomes-following-ileal-pouch-anal-anastomosis-in-patients-with-indeterminate-colitis
#4
Uri Netz, Norman J Galbraith, Stephen O'Brien, Jane Carter, Stephen Manek, Robert E Petras, Susan Galandiuk
BACKGROUND: The advisability of performing ileal pouch-anal anastomosis for patients with indeterminate colitis is debated. Indeterminate colitis is found in up to 15% of inflammatory bowel disease colectomy specimens. We determined long-term outcomes in patients diagnosed with indeterminate colitis undergoing ileal pouch-anal anastomosis. METHODS: Fifty-six patients were included with a mean follow-up of 14 ± 7 years. Long-term behavior was defined based on surgeon assessment as "Crohn disease-like" in patients who subsequently developed clear signs of Crohn disease and as "non-Crohn disease-like...
January 8, 2018: Surgery
https://www.readbyqxmd.com/read/29324371/multiple-synchronous-adenocarcinomas-of-the-small-bowel-in-a-young-patient-a-case-report
#5
Cristián Cavalla, Federico Oppliger, Giancarlo Schiappacasse, Rodrigo Valderrama, Adriana Castiblanco, Sonia Margarit
INTRODUCTION: Adenocarcinoma of the small bowel is a rare neoplasm presented usually in elder patients as a single tumor. Its presentation as multiple tumors and in young patients is exceptional and there aren't any guidelines to orient its therapy. PRESENTATION OF CASE: We present the rare case of a sixteen-year-old woman that presents to the emergency department with an intussusception due to a small bowel tumor. The resected specimen showed multiple adenocarcinomas...
December 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29319021/totally-robotic-intracorporeal-side-to-side-isoperistaltic-strictureplasty-for-crohn-s-disease
#6
Stefano Scaringi, Francesco Giudici, Daniela Zambonin, Ferdinando Ficari, Paolo Bechi
The development of bowel-sparing techniques (strictureplasties) for extended stricturing Crohn's disease (CD) and the increased use of minimally invasive surgery (wound sparing) represent the two most important improvements in inflammatory bowel disease surgery from the origin. Nevertheless, the minimally invasive approach for extended stricturing forms is usually avoided primarily because of difficulties in performing complex intracorporeal sutures. We describe a totally intracorporeal robotic ileocecal resection with a yet described modified side-to-side isoperistaltic strictureplasty for an extended ileocecal CD...
January 10, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29315694/long-term-efficacy-and-safety-of-ustekinumab-in-122-refractory-crohn-s-disease-patients-a-multicentre-experience
#7
P Wils, Y Bouhnik, P Michetti, B Flourie, H Brixi, A Bourrier, M Allez, B Duclos, M Serrero, A Buisson, A Amiot, M Fumery, X Roblin, L Peyrin-Biroulet, J Filippi, G Bouguen, V Abitbol, B Coffin, M Simon, D Laharie, B Pariente
BACKGROUND: Long-term outcome of ustekinumab in Crohn's disease (CD) has not been evaluated. AIM: To evaluate the long-term efficacy and safety of ustekinumab and identify the predictive factors of ustekinumab failure-free persistence in a cohort of anti-TNF refractory CD patients. METHODS: We performed a retrospective multicentre cohort study including all consecutive CD patients who began subcutaneous ustekinumab and presented a clinical response (defined as a significant improvement of CD-related clinical symptoms assessed by the patient's physician leading to continued ustekinumab) during the first year of treatment...
January 8, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29313266/factors-that-influence-treatment-and-non-treatment-decision-making-among-individuals-with-inflammatory-bowel-disease-an-integrative-review
#8
REVIEW
Kendra J Kamp, Kelly Brittain
Inflammatory bowel disease (IBD) is a chronic illness with periods of varying disease activity called flares and remissions. Since IBD impacts quality of life, patients make IBD disease management decisions every day. Previous research indicates limited insight about factors that influence decisions regarding disease management and the types of decisions IBD patients make. The purpose of this integrative review is to identify types of treatment and non-treatment decisions and the factors that influence decision making regarding disease management among individuals with IBD...
January 8, 2018: Patient
https://www.readbyqxmd.com/read/29309774/glycosylation-of-immunoglobulin-g-associates-with-clinical-features-of-inflammatory-bowel-diseases
#9
Mirna Šimurina, Noortje de Haan, Frano Vučković, Nicholas A Kennedy, Jerko Štambuk, David Falck, Irena Trbojević-Akmačić, Florent Clerc, Genadij Razdorov, Anna Khon, Anna Latiano, Renata D'Incà, Silvio Danese, Stephan Targan, Carol Landers, Marla Dubinsky, Dermot P B McGovern, Vito Annese, Manfred Wuhrer, Gordan Lauc
BACKGROUND AND AIMS: Causes of inflammatory bowel diseases are not well understood and the most prominent forms Crohn's disease (CD) and ulcerative colitis (UC) are sometimes hard to distinguish. Glycosylation of immunoglobulin G (IgG) has been associated with CD and UC. IgG Fc-glycosylation affects IgG effector functions. We evaluated changes in IgG Fc-glycosylation associated with UC and CD, as well as with disease characteristics in different patient groups. METHODS: We analyzed 3441 plasma samples, obtained from 2 independent cohorts of patients with CD (874 patients in Italy and 391 in the United States [US]) or UC (1056 in Italy and 253 in the US and healthy individuals (controls) (427 in Italy and 440 in the US)...
January 5, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29300851/magnetic-resonance-imaging-predicts-histopathologic-composition-of-ileal-crohn-s-disease
#10
Mathilde Wagner, Huaibin Mabel Ko, Manjil Chatterji, Cecilia Besa, Joana Torres, Xiaofei Zhang, Hinaben Panchal, Stefanie Hectors, Judy Cho, Jean-Frederic Colombel, Noam Harpaz, Bachir Taouli
Background and aims: Recently, smooth muscle hypertrophy has been suggested to be a contributor in small bowel lesions secondary to Crohn's disease (CD), in addition to inflammation and fibrosis. Here, we assess the value of magnetic resonance imaging (MRI) for the characterization of histopathologic tissue composition of small bowel CD, including inflammation, fibrosis and smooth muscle hypertrophy. Methods: 35 consecutive patients (M/F 17/18, mean age 33y) with ileal CD who underwent small bowel resection (for stricture in 27 patients) and a preoperative contrast-enhanced MRI exam within one month before surgery were retrospectively included...
January 2, 2018: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29300710/anti-tnf-therapy-is-associated-with-an-increased-risk-of-postoperative-morbidity-after-surgery-for-ileocolonic-crohn-disease-results-of-a-prospective-nationwide-cohort
#11
Antoine Brouquet, Léon Maggiori, Philippe Zerbib, Jérémie H Lefevre, Quentin Denost, Adeline Germain, Eddy Cotte, Laura Beyer-Berjot, Nicolas Munoz-Bongrand, Véronique Desfourneaux, Amine Rahili, Jean-Pierre Duffas, Karine Pautrat, Christine Denet, Valérie Bridoux, Guillaume Meurette, Jean-Luc Faucheron, Jérome Loriau, Françoise Guillon, Eric Vicaut, Stéphane Benoist, Yves Panis
OBJECTIVE: To determine the risk factors of morbidity after surgery for ileocolonic Crohn disease (CD). SUMMARY BACKGROUND DATA: The risk factors of morbidity after surgery for CD, particularly the role of anti-TNF therapy, remain controversial and have not been evaluated in a large prospective cohort study. METHODS: From 2013 to 2015, data on 592 consecutive patients who underwent surgery for CD in 19 French specialty centers were collected prospectively...
February 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29290660/efficacy-of-noninvasive-evaluations-in-monitoring-inflammatory-bowel-disease-activity-a-prospective-study-in-china
#12
Jin-Min Chen, Tao Liu, Shan Gao, Xu-Dong Tong, Fei-Hong Deng, Biao Nie
AIM: To optimize the efficacy of noninvasive evaluations in monitoring the endoscopic activity of inflammatory bowel disease (IBD). METHODS: Fecal calprotectin (FC), clinical activity index (CDAI or CAI), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) were measured for 136 IBD patients. Also, FC was measured in 25 irritable bowel syndrome (IBS) patients that served as controls. Then, endoscopic activity was determined by other two endoscopists for colonic or ileo-colonic Crohn's disease (CICD) with the "simple endoscopic score for Crohn's disease" (SES-CD), CD-related surgery patients with the Rutgeerts score, and ulcerative colitis (UC) with the Mayo score...
December 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29289343/rates-and-trends-for-inpatient-surgeries-in-pediatric-crohn-s-disease-in-the-united-states-from-2003-to-2012
#13
Audrey L Stokes, Afif N Kulaylat, Dorothy V Rocourt, Christopher S Hollenbeak, Walter Koltun, Tolulope Falaiye
BACKGROUND: Pediatric Crohn's disease (CD) is increasing in incidence globally. Trends in specific types of inpatient pediatric CD-related surgical procedures have not been widely reported. METHODS: Patients ≤20 years of age with CD were identified in the Kids' Inpatient Database for 2003, 2006, 2009, and 2012. Bowel resection, stoma creation, and perianal or percutaneous drainage procedures were identified using ICD-9 procedure codes, and trends were identified...
December 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29285682/efficacy-of-autologous-fat-graft-injection-in-the-treatment-of-anovaginal-fistulas
#14
S Norderval, L Lundby, H Hougaard, S Buntzen, S Weum, L de Weerd
BACKGROUND: Injection of autologous fat is an established method within plastic surgery for soft tissue augmentation. The aim of the present study was to determine whether transperineal fat graft injection could promote healing of anovaginal fistulas. METHODS: The procedures were performed at the University Hospital of North Norway, Tromsø, Norway, and at Aarhus University Hospital, Aarhus, Denmark, between May 2009 and September 2016. After abdominal liposuction, fat was injected around the fistula tract that was finally transected percutaneously with a sharp cannula and fat injected between the cut parts...
December 28, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29285681/outcomes-of-ileal-pouch-anal-anastomosis-without-primary-diverting-loop-ileostomy-if-postoperative-sepsis-develops
#15
O A Lavryk, T L Hull, L C Duraes, L Stocchi, J H Ashburn, D Liska, E Gorgun, H Kessler
BACKGROUND: The aim of the present study was to assess the short-term and long-term consequences of diverting loop ileostomy (DLI) omission in ileal pouch-anal anastomosis (IPAA) surgery complicated by postoperative pelvic sepsis. METHODS: This was a retrospective review of a prospectively maintained database. Of 4031 patients who underwent IPAA in 1983-2014, 357 developed IPAA-related pelvic sepsis with or without anastomotic dehiscence. Patients with Crohn's disease or cancer were excluded...
December 28, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29282629/inflammatory-bowel-disease-is-not-a-contraindication-for-bariatric-surgery
#16
Stephanie Aelfers, Ignace M C Janssen, Edo O Aarts, Carolijn Smids, Marcel J Groenen, Frits J Berends
BACKGROUND: Inflammatory bowel diseases (IBD) are listed as a contraindication for bariatric surgery in various guidelines due to a theoretical higher complication risk. Therefore, little is known about safety and efficacy of bariatric surgery in IBD patients. AIM: We assessed the safety and efficacy of bariatric surgery and postoperative quality of life (QoL) in IBD patients. SETTING: The study was conducted in a large peripheral hospital in the Netherlands...
December 27, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29280707/successful-conservative-treatment-of-enterocutaneous-fistula-with-cyanoacrylate-surgical-sealant-case-report
#17
N Musa, F Aquilino, P Panzera, G Martines
AIM: Enterocutaneous (EC) fistula is an abnormal communication between the gastrointestinal tract and the skin. The majority of EC fistulas result from surgery. Only 15-25% of EC fistulas are spontaneous and they often result from underlying diseases such as Crohn's disease, radiation and chemotherapy. CASE REPORT: A 62-year old woman who, in 2012, underwent Pylorus-preserving cephalic pancreaticoduodenectomy (PPPD sec. Traverso-Longmire), due to an advanced pancreatic ductal adenocarcinoma (pT3N1M1)...
September 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29277619/epithelioid-granulomas-associate-with-increased-severity-and-progression-of-crohn-s-disease-based-on-6-year-follow-up
#18
Christopher M Johnson, Douglas J Hartman, Claudia Ramos-Rivers, Bhavana Bhagya Rao, Abhik Bhattacharya, Miguel Regueiro, Marc Schwartz, Jason Swoger, Jana Al Hashash, Arthur Barrie, Timothy P Pfanner, Michael Dunn, Ioannis E Koutroubakis, David G Binion
BACKGROUND & AIMS: Epithelioid granulomas are characteristics of a subset of patients with Crohn's disease (CD), but their significance, with regard to disease progression and severity, is unclear. We investigated the relationship between granulomas and CD severity over a 6-year time period in a large cohort of patients. METHODS: We performed a retrospective study of patients with CD seen at the Inflammatory Bowel Disease Center at the University of Pittsburgh; data were collected from 2009 through 2014 and patients were assigned to groups with and without histologic evidence of granuloma...
December 22, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29250800/postoperative-outcomes-in-vedolizumab-treated-crohn-s-disease-patients-undergoing-major-abdominal-operations
#19
A L Lightner, N P McKenna, C S Tse, L E Raffals, E V Loftus, K L Mathis
BACKGROUND: Up to 80% of patients with Crohn's disease require an abdominal operation in their lifetime. As the use of vedolizumab is increasing for the treatment of Crohn's disease, it is important to understand its potential association with post-operative complications. AIM: We sought to compare 30-day postoperative infectious complication rate among vedolizumab-treated Crohn's disease patients vs those who had received TNFα inhibitors or no biologic therapy...
December 18, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29243105/comparative-effectiveness-of-infliximab-versus-adalimumab-in-patients-with-biologic-na%C3%A3-ve-crohn-s-disease
#20
Amine Benmassaoud, Talal Al-Taweel, Mark Solomon Sasson, Dasha Moza, Matthew Strohl, Uri Kopylov, Laurence Paradis-Surprenant, Mohanad Almaimani, Alain Bitton, Waqqas Afif, Peter L Lakatos, Talat Bessissow
BACKGROUND: Direct head-to-head studies comparing the long-term outcomes of infliximab (IFX) to adalimumab (ADA) in Crohn's disease (CD) are sparse. AIMS: We compared the short-term and long-term efficacy and safety of IFX and ADA in CD. METHODS: We performed a single-center retrospective study including biologic-naïve adult patients with CD who were started on IFX or ADA at the McGill University Health Center. The primary end points were clinical response and remission at 12 months...
December 14, 2017: Digestive Diseases and Sciences
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