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Crohn fistula

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https://www.readbyqxmd.com/read/29353847/-diagnosis-and-treatment-of-six-patients-with-crohn-s-disease-complicated-by-recto-perineal-urethral-fistula
#1
Hirosuke Kuroki, Kazutaka Koganei, Kenji Tatsumi, Ryo Futatsuki, Kyoko Yamada, Katsuhiko Arai, Nao Obara, Hideaki Kimura, Akira Sugita, Tsuneo Fukushima
Recto-perineal-urethral fistula caused by Crohn's disease is a rare, for which fundamental treatment has not been established yet. We analyzed the clinical characteristics, diagnosis, treatment, and prognosis of six male patients with anorectal lesions caused by Crohn's disease. Three patients were treated with abdominoperineal resection and the other three with rectal excision without anastomosis. Excluding one case, which presented worsening immediately after surgery, symptoms of urethral fistula improved without urethral stenosis, dysuria, or sexual dysfunction...
2018: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/29346350/epithelial-mesenchymal-transition-in-crohn-s-disease
#2
REVIEW
H Jiang, J Shen, Z Ran
Crohn's disease (CD) is often accompanied by the complications of intestinal strictures and fistulas. These complications remain obstacles in CD treatment. In recent years, the importance of epithelial-mesenchymal transition in the pathogenesis of CD-associated fistulas and intestinal fibrosis has become apparent. Epithelial-mesenchymal transition refers to a dynamic change, wherein epithelial cells lose their polarity and adherence and acquire migratory function and fibroblast features. During formation of CD-associated fistulas, intestinal epithelial cells dislocate from the basement membrane and migrate to the lining of the fistula tracts, where they convert into transitional cells as a compensatory response under the insufficient wound healing condition...
December 20, 2017: Mucosal Immunology
https://www.readbyqxmd.com/read/29331943/modern-management-of-perianal-fistulas-in-crohn-s-disease-future-directions
#3
REVIEW
Paulo Gustavo Kotze, Bo Shen, Amy Lightner, Takayuki Yamamoto, Antonino Spinelli, Subrata Ghosh, Remo Panaccione
Perianal fistulae in patients with Crohn's disease (CD) can be associated with significant morbidity resulting in negative impact on quality of life. The last two decades have seen significant advancements in the management of perianal fistulas in CD, which has evolved into a multidisciplinary approach that includes gastroenterologists, colorectal surgeons, endoscopists and radiologists. Despite the introduction of new medical therapies such as antitumour necrosis factor and novel models of care delivery, the best fistula healing rates reported with combined medical and surgical approaches are approximately 50%...
January 13, 2018: Gut
https://www.readbyqxmd.com/read/29321063/first-clinical-case-report-of-local-microinjection-of-autologous-fat-and-adipose-derived-stromal-vascular-fraction-for-perianal-fistula-in-crohn-s-disease
#4
Cécile Philandrianos, Mélanie Serrero, Fanny Grimaud, Jérémy Magalon, Carine Visée, Mélanie Velier, Pauline Francois, Pierre Orsoni, Guy Magalon, Jean-Charles Grimaud, Ariadne Desjeux, Julie Véran, Florence Sabatier
Mesenchymal stem cell therapy is a promising treatment for perianal Crohn's fistulas refractory to conventional therapy, which are an extremely morbid complication and a true therapeutic challenge. Autologous adipose-derived stromal vascular fraction (ADSVF) is an easily accessible source of cells with angiogenic, anti-inflammatory, immunomodulatory, and regenerative properties. Here, we describe a case involving a patient with severe perianal Crohn's fistulas refractory to the best medical and surgical practices who received local treatment with ADSVF and microfat...
January 10, 2018: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/29316139/stem-cell-therapy-in-refractory-perineal-crohn-s-disease-long-term-follow-up
#5
Claudio Wainstein, Rodrigo Quera, Daniela Fluxá, Udo Kronberg, Alejandro Conejero, Francisco López-Köstner, Claudio Jofre, Alejandro J Zarate
AIM: To describe the long-term outcomes of adipose-mesenchymal stem cells, platelet-rich plasma, and endorectal advancement flaps in patients with Perineal Crohn's Disease. METHOD: This was a single-center, prospective, observational pilot study performed between March 2013 and December 2016. The study included adult patients diagnosed with Perianal Crohn's Disease (with complex perianal fistulas) refractory to previous surgical and/or biological treatment. Patients underwent surgical treatment in two stages...
January 6, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29300851/magnetic-resonance-imaging-predicts-histopathologic-composition-of-ileal-crohn-s-disease
#6
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/29287012/magnetic-resonance-enterography-cannot-replace-upper-endoscopy-in-pediatric-crohn-s-disease-an-imagekids-sub-study
#7
Peter C Church, Ruth Cytter Kuint, Oren Ledder, Victor M Navas-López, Malgorzata Sladek, Annecarin Brückner, Robert N Baldassano, Batia Weiss, Baruch Yerushalmi, Shehzad A Saeed, Jeffrey Hyams, Anthony Otley, Anne M Griffiths, Dan Turner, Mary-Louise C Greer
OBJECTIVES: While magnetic resonance enterography (MRE) can accurately reflect ileal inflammation in pediatric Crohn's disease (CD), there are no pediatric data on the accuracy of MRE to detect upper gastrointestinal tract (UGI) lesions. We aimed to compare MRE and esophagogastroduodenoscopy (EGD) in detecting the spectrum and severity of UGI disease in children. METHODS: This is an ancillary study of the prospective multi-center ImageKids study focusing on pediatric MRE...
December 28, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29285682/efficacy-of-autologous-fat-graft-injection-in-the-treatment-of-anovaginal-fistulas
#8
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/29280707/successful-conservative-treatment-of-enterocutaneous-fistula-with-cyanoacrylate-surgical-sealant-case-report
#9
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/29277560/long-term-efficacy-and-safety-of-stem-cell-therapy-cx601-for-complex-perianal-fistulas-in-patients-with-crohn-s-disease
#10
Julián Panés, Damián García-Olmo, Gert Van Assche, Jean Frederic Colombel, Walter Reinisch, Daniel C Baumgart, Axel Dignass, Maria Nachury, Marc Ferrante, Lili Kazemi-Shirazi, Jean C Grimaud, Fernando de la Portilla, Eran Goldin, Marie Paule Richard, Mary Carmen Diez, Ignacio Tagarro, Anne Leselbaum, Silvio Danese
BACKGROUND & AIMS: Therapies for perianal fistulas in patients with Crohn's disease (CD) are often ineffective in producing long-term healing. We performed a randomized placebo-controlled trial to determine the long-term efficacy and safety of a single local administration of allogeneic expanded adipose-derived stem cells (Cx601) in patients with CD and perianal fistulas. METHODS: We performed a double-blind study at 49 hospitals in Europe and Israel, comprising 212 patients with CD and treatment-refractory, draining, complex perianal fistulas...
December 22, 2017: Gastroenterology
https://www.readbyqxmd.com/read/29275447/old-and-new-lymphocyte-players-in-inflammatory-bowel-disease
#11
REVIEW
Paolo Giuffrida, Gino Roberto Corazza, Antonio Di Sabatino
Inflammatory bowel disease (IBD), encompassing Crohn's disease and ulcerative colitis, is a chronic intestinal inflammatory disorder characterized by diffuse accumulation of lymphocytes in the gut mucosa as a consequence of over-expression of endothelial adhesion molecules. The infiltrating lymphocytes have been identified as subsets of T cells, including T helper (Th)1 cells, Th17 cells, and regulatory T cells. The function of these lymphocyte subpopulations in the development of IBD is well-known, since they produce a number of pro-inflammatory cytokines, such as interferon-γ and interleukin-17A, which in turn activate mucosal proteases, thus leading to the development of intestinal lesions, i...
December 23, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29232211/improving-the-understanding-of-perianal-crohn-fistula-through-3d-modeling
#12
Kapil Sahnan, Samuel O Adegbola, Phillip J Tozer, Arun Gupta, Rachel Baldwin-Cleland, Nuha Yassin, Janindra Warusavitarne, Omar D Faiz, Ailsa L Hart, Robin K S Phillips, Phillip F C Lung
No abstract text is available yet for this article.
December 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29215479/major-abdominal-and-perianal-surgery-in-crohn-s-disease-long-term-follow-up-of-australian-patients-with-crohn-s-disease
#13
MULTICENTER STUDY
James W T Toh, Nelson Wang, Christopher J Young, Matthew J F X Rickard, Anil Keshava, Peter Stewart, Viraj Kariyawasam, Rupert Leong
BACKGROUND: Most patients with Crohn's disease still require surgery despite significant advances in medical therapy, surveillance, and management strategies. OBJECTIVE: The purpose of this study was to assess surgical strategies and outcomes in Crohn's disease, including surgical recurrence and emergency surgery. DESIGN: This was a multicenter, retrospective review of a prospectively collected database. SETTINGS: A specialist-referred cohort of patients with Crohn's disease between 1970 and 2009 was studied...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29209921/fourteen-year-anti-tnf-therapy-in-crohn-s-disease-patients-clinical-characteristics-and-predictive-factors
#14
Aisaku Osamura, Yasuo Suzuki
BACKGROUND: Crohn's disease (CD) is an intractable disease that requires long-term treatment. Tumor necrosis factor (TNF) inhibitors have strong efficacy and are widely used for CD treatment. However, a loss of response is one of the issues in long-term TNF therapy. To identify the factors affecting the efficacy of long-term CD treatment with TNF inhibitors, we conducted a retrospective study of treatment outcomes and clinical factors using clinical data over a 14-year period. METHODS: Clinical characteristics and factors for surgery, hospitalization, and TNF inhibitor treatment discontinuation were examined in 219 biologic-naïve patients who were treated with TNF inhibitors at our hospital before October 2014...
December 5, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29204155/a-meta-analysis-of-adalimumab-for-fistula-in-crohn-s-disease
#15
REVIEW
Yin-Mei Fu, Ming Chen, Ai-Jun Liao
Purpose: This study aimed to evaluate the therapeutic value of adalimumab (ADA) for fistula in Crohn's disease (CD). Methods: A computerized search of electronic databases, including PubMed, Web of Science, Embase, Google scholar, and the Cochrane Library from 2000 to October 2016, was performed. Randomized controlled trials (rcts) or nonrandomized controlled trials (n-rcts) were included in this article to evaluate the role of ADA in the management of fistula in CD...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29199142/high-risk-of-anal-and-rectal-cancer-in-patients-with-anal-and-or-perianal-crohn-s-disease
#16
Laurent Beaugerie, Fabrice Carrat, Stéphane Nahon, Jean-David Zeitoun, Jean-Marc Sabate, Laurent Peyrin-Biroulet, Jean-Frédéric Colombel, Matthieu Allez, Jean-François Fléjou, Julien Kirchgesner, Magali Svrcek
BACKGROUND AND AIMS: Little is known about the magnitude of the risk of anal and rectal cancer in patients with anal and/or perineal Crohn's disease. We aimed to assess the risk of anal and rectal cancer in patients with Crohn's perianal disease followed in the Cancers Et Surrisque Associé aux Maladies inflammatoires intestinales En France (CESAME) cohort. METHODS: We collected data from 19,486 patients with Inflammatory Bowel Disease (IBD) enrolled in the observational CESAME study in France, from May 2004 through June 2005; 14...
November 30, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29162069/martius-flap-for-recurrent-perineal-and-rectovaginal-fistulae-in-a-patient-with-crohn-s-disease-endometriosis-and-a-mullerian-anomaly
#17
Gaetano Gallo, Alberto Realis Luc, Giuseppe Clerico, Mario Trompetto
BACKGROUND: Rectovaginal fistulas represent 5% of all anorectal fistulae and are a disastrous manifestation of Crohn's disease that negatively affects patients' social and sexual quality of life. Treatment remains challenging for colorectal surgeons, and the recurrence rate remains high despite the numerous available options. CASE PRESENTATION: We describe a 31-year-old female patient with a Crohn's disease-related recurrent perineo-vaginal and recto-vaginal fistulae and a concomitant mullerian anomaly...
November 21, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29147878/knowledge-gaps-in-the-management-of-postoperative-crohn-s-disease-a-us-national-survey
#18
Vu Q Nguyen, Jessica L Mays, Marissa Lang, Yingxing Wu, Themistocles Dassopoulos, Miguel Regueiro, Alan Moss, Deborah D Proctor, Dario Sorrentino
BACKGROUND: Postoperative recurrence (POR) of Crohn's disease (CD) is common. Guidelines on POR management have recently been issued, but clinical practice may vary. AIMS: To examine the current clinical practice of POR management in the USA METHODS: A web-based survey was sent to all members of the American Gastroenterological Association and the American College of Gastroenterology. The survey consisted of multiple-choice questions with clinical scenarios to assess how participants manage POR...
November 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29143190/role-of-magnetic-resonance-imaging-in-the-management-of-perianal-crohn-s-disease
#19
REVIEW
Jose C Gallego, Ana Echarri
Perianal fistulas are a major problem in many patients with Crohn's disease. These are usually complex fistulas that adversely affect patients' quality of life, and their clinical management is difficult. Medical treatment sometimes achieves cessation of discharge and closure of the external opening; however, it is difficult to assess the status of the rest of the fistula tract. Magnetic resonance imaging is the method of choice with which to evaluate the condition of perianal fistulas and allows for assessment of the status of inaccessible areas...
November 15, 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/29139091/pharmacological-approach-to-the-management-of-crohn-s-disease-patients-with-perianal-disease
#20
REVIEW
Fernando Bermejo, Iván Guerra, Alicia Algaba, Antonio López-Sanromán
Perianal localization of Crohn's disease involves significant morbidity, affects quality of life and results in an increased use of healthcare resources. Medical and surgical therapies contribute to its management. The objective of this review is to address the current understanding in the management of perianal Crohn's disease, with the main focus in reviewing pharmacological therapies, including stem cells. In complex fistulas, once local sepsis has been controlled by surgical drainage and/or antibiotics, anti-TNF drugs (infliximab, adalimumab) are the first-line therapy, with or without associated immunomodulators...
January 2018: Drugs
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