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https://www.readbyqxmd.com/read/28527172/metastatic-crohn-s-disease
#1
Deepak N Amarapurkar, Amey Sonavane, Anjali D Amarapurkar
Metastatic cutaneous involvement is a rare extraintestinal manifestation of Crohn's disease. Presence of cutaneous noncaseating granulomas that are anatomically noncontiguous in location with a fistula or the gastrointestinal tract is a diagnostic hallmark. We present a case of inflammatory bowel disease initially diagnosed as ulcerative colitis, but later manifesting as intra-abdominal abscesses and ulcerated cutaneous lesions that on biopsy proved to be metastatic Crohn's disease. The patient promptly responded to corticosteroid therapy...
April 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28522947/clinical-efficacy-of-adalimumab-versus-infliximab-and-the-factors-associated-with-recurrence-or-aggravation-during-treatment-of-anal-fistulas-in-crohn-s-disease
#2
Cheng-Chun Ji, Shota Takano
BACKGROUND/AIMS: Infliximab has proven to be effective in the treatment of perianal fistulas in Crohn's disease (CD) but the efficacy of adalimumab is still unclear. The aim of this study is to assess the clinical efficacy of adalimumab and compare the results with those for infliximab. METHODS: Forty-seven CD patients treated for perianal fistulas with infliximab from September 2005 to December 2010 (n=31), or with adalimumab from November 2010 to May 2012 (n=16), were enrolled in this retrospective study...
April 2017: Intestinal Research
https://www.readbyqxmd.com/read/28522942/adalimumab-or-infliximab-which-is-better-for-perianal-fistula-in-crohn-s-disease
#3
EDITORIAL
Jong Pil Im
No abstract text is available yet for this article.
April 2017: Intestinal Research
https://www.readbyqxmd.com/read/28489647/obesity-bariatric-surgery-and-crohn-s-disease
#4
Burton I Korelitz, Niket Sonpal, Judy Schneider, Arun Swaminath, Joseph Felder, Mitchell Roslin, Jeffrey Aronoff
BACKGROUND: Crohn's disease (CD) following bariatric surgery has been previously described. It is not clear whether the clinical entity is due to rapid metabolism of fat, change in the bacterial milieu of the bowel, the loss of defense mechanisms of the stomach, or even a coincidence. OBJECTIVES: To present observations which might serve to sort out these various etiologies. DESIGN: We present 5 cases of colitis, ileocolitis or enteritis, some with fistula formation, with clinical onset following bariatric surgery and add these to the 7 cases previously identified as CD reported elsewhere...
May 9, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28487805/squamous-cell-carcinoma-originating-from-a-crohn-s-enterocutaneous-fistula
#5
Bogdan Protyniak, Travis Shutt, Russell Farmer
Purpose. Squamous cell carcinoma (SCC) developing within fistulae and chronic wounds in patients with Crohn's disease is a rare phenomenon with few reported studies in the literature. Clinical suspicion for SCC in Crohn's disease patients with chronic painful fistulae is low, leading to delayed diagnosis and treatment. We present a patient with long-standing Crohn's disease complicated by malignant degeneration of an enterocutaneous fistula tract. Methods. Workup with MRI, CT, and fistulogram revealed a 7 × 3 cm fistulous connection between a loop of small intestine and the patient's perineum...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28469212/urine-dripping-from-the-sigmoid-wall-in-a-patient-with-suspected-crohn-s-disease-an-unusual-manifestation-of-a-colonovesical-fistula
#6
Ren Mao, Ning Zhang, Yao He, Yi Cui, Shomron Ben-Horin, Min-Hu Chen
No abstract text is available yet for this article.
May 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28465780/laparoscopic-surgery-for-complex-and-recurrent-crohn-s-disease
#7
EDITORIAL
Yusuf Sevim, Cihangir Akyol, Erman Aytac, Bilgi Baca, Orhan Bulut, Feza H Remzi
Crohn's disease (CD) is a chronic inflammatory disease of digestive tract. Approximately 70% of patients with CD require surgical intervention within 10 years of their initial diagnosis, despite advanced medical treatment alternatives including biologics, immune suppressive drugs and steroids. Refractory to medical treatment in CD patients is the common indication for surgery. Unfortunately, surgery cannot cure the disease. Minimally invasive treatment modalities can be suitable for CD patients due to the benign nature of the disease especially at the time of index surgery...
April 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28462237/endoscopic-fistulotomy-heals-a-y-shaped-entero-entero-cutaneous-fistula
#8
Helen Lee, Bo Shen
Patients may develop fistulas due to Crohn's disease or as a postoperative complication after restorative proctocolectomy with ileal pouch anal anastomosis. Unfortunately, the treatment of fistulas can be challenging. The current standard of care may include medical therapy and/or surgical intervention. However, endoscopic treatment for postoperative pouch complications has emerged as a valid alternative option. We describe a case of persistent drainage from a Y-shaped entero-entero-cutaneous fistula that resolved after endoscopic fistulotomy with needle knife...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28458507/endoscopy-and-cross-sectional-imaging-for-assessing-crohn-s-disease-activity
#9
Ryan W Stidham, Raymond K Cross
Crohn's disease (CD) is principally characterized by chronic and recurrent inflammation of the gastrointestinal tract, most commonly found in the ileo-colonic region. The chronicity and severity of intestinal inflammation together contribute to progressive, cumulative, deep, transmural intestinal damage, including stricturing, obstruction, abscesses, and fistulae. Both intestinal inflammation and its chronic complications result in a range of symptoms subsequently leading to patient presentations with diarrhea, abdominal pain, and anemia related to intestinal blood loss...
July 2016: Techniques in Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28453755/association-of-induction-infliximab-levels-with-clinical-response-in-perianal-crohn-s-disease
#10
Yana Davidov, Bella Ungar, Haggai Bar-Yoseph, Dan Carter, Ola Haj-Natour, Miri Yavzori, Yehuda Chowers, Rami Eliakim, Shomron Ben-Horin, Uri Kopylov
Background: The association of infliximab [IFX] trough levels with clinical and endoscopic outcomes in inflammatory bowel disease is well established. However, there is scarce data regarding the association of perianal fistula response with IFX. The aim of this study was to establish whether early induction infliximab levels and anti-infliximab antibodies [ATIs] are associated with perianal fistula response. Methods: Consecutive CD patients with perianal fistulae that were treated with IFX between 2008 and 2016 were included in the study...
May 1, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28427855/outcome-of-medical-management-of-intraabdominal-abscesses-in-children-with-crohn-s-disease
#11
Razan H Alkhouri, Gracielle Bahia, Ashley C Smith, Richard Thomas, Christine Finck, Wael Sayej
INTRODUCTION: Crohn's disease (CD) is a chronic inflammatory condition of the gastrointestinal tract that is complicated by fistulas, strictures, and intraabdominal abscesses (IAA) in 10%-30% of patients. To avoid surgical resection of the bowel, medical therapy with antibiotics (Ab) with or without percutaneous drainage (PD) is first undertaken. Our objectives are to examine the outcome of IAA in CD patients treated with antibiotics alone vs antibiotics and PD, and to identify risk factors for medical therapy failure...
March 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28426675/indicators-of-suboptimal-biologic-therapy-over-time-in-patients-with-ulcerative-colitis-and-crohn-s-disease-in-the-united-states
#12
Haridarshan Patel, Trevor Lissoos, David T Rubin
This study assessed the occurrence of indicators for suboptimal biologic therapy among ulcerative colitis (UC) and Crohn's disease (CD) patients over time in the United States (US). Data from a large US claims database (2005-2013) were used to retrospectively identify patients with diagnosed with either UC or CD who were new biologic users. Indicators of suboptimal biologic therapy included: dose escalation during the maintenance phase, discontinuation of the initial biologic, switch to another biologic within 90 days following the last day of supply of the initial biologic, augmentation with a non-biologic systemic therapy, UC- or CD-related surgery, UC- or CD-related urgent care, and development of fistula (for CD only)...
2017: PloS One
https://www.readbyqxmd.com/read/28416240/efficacy-of-tumour-necrosis-factor-antagonists-in-stricturing-crohn-s-disease-a-tertiary-center-real-life-experience
#13
Mariangela Allocca, Cristiana Bonifacio, Gionata Fiorino, Antonino Spinelli, Federica Furfaro, Luca Balzarini, Stefanos Bonovas, Silvio Danese
BACKGROUND: Stenosis is the most common complication of Crohn's disease (CD). Long-term outcome of patients receiving tumour necrosis factor (TNF) antagonists for such disease complication is poorly understood. METHODS: 51 CD patients (from July 2006 to November 2015) who had a diagnosis of small bowel or colonic stenosis, diagnosed by colonoscopy and/or MRI enterography, and were treated with TNF antagonists (adalimumab or infliximab) were enrolled. The primary outcome was to assess the rate of success of TNF antagonists on avoiding abdominal surgery for stricturing CD patients...
March 30, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28406887/hospitalizations-for-crohn-s-disease-united-states-2003-2013
#14
Christopher A Malarcher, Anne G Wheaton, Yong Liu, Sujay F Greenlund, Suraj J Greenlund, Hua Lu, Janet B Croft
In 2009, an estimated 565,000 Americans had Crohn's disease (1), an inflammatory bowel disorder that can affect any part of the gastrointestinal tract. Symptoms include persistent diarrhea, abdominal cramps and pain, constipation leading to bowel obstruction, and rectal bleeding.* Symptoms sometimes intensify in severity and require hospitalization and surgeries of the small intestine, colon, or rectum (2). Hospital discharge data from the National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) were used to estimate U...
April 14, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28401425/medical-therapies-for-stricturing-crohn-s-disease-efficacy-and-cross-sectional-imaging-predictors-of-therapeutic-failure
#15
Cécile Campos, Antoine Perrey, Céline Lambert, Bruno Pereira, Marion Goutte, Anne Dubois, Felix Goutorbe, Michel Dapoigny, Gilles Bommelaer, Constance Hordonneau, Anthony Buisson
BACKGROUND: Medical therapy efficacy remains controversial in stricturing Crohn's disease. Cross-sectional imaging, especially magnetic resonance imaging, has been suggested as very helpful to guide therapeutic decision making. AIM: To assess efficacy and predictors of therapeutic failure in patients receiving medical treatments for stricturing Crohn's disease. METHODS: In this retrospective study, therapeutic failure was defined as symptomatic stricture leading to surgical or endoscopic therapeutics, hospitalization, treatment discontinuation or additional therapy and short-term clinical response as clinical improvement assessed by two physicians...
April 11, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28401051/surgery-in-pediatric-crohn-s-disease-indications-timing-and-post-operative-management
#16
REVIEW
Seung Kim
Pediatric onset Crohn's disease (CD) tends to have complicated behavior (stricture or penetration) than elderly onset CD at diagnosis. Considering the longer duration of the disease in pediatric patients, the accumulative chance of surgical treatment is higher than in adult onset CD patients. Possible operative indications include perianal CD, intestinal stricture or obstruction, abdominal abscess or fistula, intestinal hemorrhage, neoplastic changes and medically untreatable inflammation. Growth retardation is an operative indication only for pediatric patients...
March 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28400193/autologous-mesenchymal-stem-cells-applied-in-a-bioabsorbable-matrix-for-treatment-of-perianal-fistulas-in-patients-with-crohn-s-disease
#17
Allan B Dietz, Eric J Dozois, Joel G Fletcher, Greg W Butler, Darcie Radel, Amy L Lightner, Maneesh Dave, Jessica Friton, Asha Nair, Emily T Camilleri, Amel Dudakovic, Andre J van Wijnen, William A Faubion
In patients with Crohn's disease (CD), perianal fistulas frequently recur, causing substantial morbidity. We performed a 12 patient, 6 month phase I trial to determine whether autologous mesenchymal stem cells (MSCs), applied in a bioabsorbable matrix, can heal the fistula. Fistula repair was not associated with any serious adverse events related to MSCs or plug placement. At 6 months, 10/12 patients (83%) had complete clinical healing and radiographic markers of response. We found placement of MSC-coated matrix fistula plugs in 12 patients with chronic perianal fistulas to be safe and lead to clinical healing and radiographic response in 10 patients...
April 8, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28399604/transperineal-ultrasound-for-perianal-fistulas-and-abscesses-a-systematic-review-and-meta-analysis
#18
Giovanni Maconi, Maria Teresa Greco, Anil Kumar Asthana
Purpose Transperineal ultrasound (TPUS) is a practical tool for assessing perianal inflammatory lesions. We systematically review its accuracy for detecting and classifying perianal fistulae and abscesses. Method The National Library of Medicine and Embase were searched for articles on TPUS for the assessment of idiopathic and Crohn's perianal fistulae and abscesses. Two reviewers independently reviewed eligible studies and rated them for quality using the QUADAS tool. The primary outcome measure was the accuracy of TPUS as measured by its sensitivity and positive predictive value (PPV) in detecting and classifying perianal fistulae, internal openings and perianal abscesses...
April 11, 2017: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/28395390/surgical-treatment-of-rectovaginal-fistula-in-crohn-s-disease-a-tertiary-center-experience
#19
Giovanni Milito, Giorgio Lisi, Dario Venditti, Michela Campanelli, Elena Aronadio, Michele Grande
BACKGROUND: Rectovaginal fistula (RVF) is a disastrous complication of Crohn's disease (CD) that is exceedingly difficult to treat. It is a disabling condition that negatively impacts a woman's quality of life. Current treatment algorithms range from observation to medical management to the need for surgical intervention. A wide variety of success rates have been reported for all management options. The choice of surgical repair methods depends on various fistula and patient characteristics, and its published success rates vary with initial success being around 50% rising to 80% with repeated surgery...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28394805/factors-associated-with-fecal-incontinence-in-women-of-childbearing-age-with-crohn-s-disease
#20
Charlène Brochard, Laurent Siproudhis, Jean Levêque, Amélie Grouin, Anne-Laure Mallet, Jean-François Bretagne, Alain Ropert, Guillaume Bouguen
BACKGROUND: Fecal incontinence is common in women with Crohn's disease, but little is known about the impact of childbirth, perianal Crohn's disease, and past surgical history on fecal incontinence. METHODS: Self-administered questionnaires were mailed to consecutive women referred to a tertiary gastroenterology centre with a focus on fecal incontinence and childbirth. These data were cross-referenced with a prospective database of the same patients' own Crohn's disease histories...
May 2017: Inflammatory Bowel Diseases
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