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Crohn fistula

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https://www.readbyqxmd.com/read/28929282/anoperineal-lesions-in-crohn-s-disease-french-recommendations-for-clinical-practice
#1
REVIEW
D Bouchard, L Abramowitz, G Bouguen, C Brochard, A Dabadie, V de Parades, M Eléouet-Kaplan, N Fathallah, J-L Faucheron, L Maggiori, Y Panis, F Pigot, P Rouméguère, A Sénéjoux, L Siproudhis, G Staumont, J-M Suduca, B Vinson-Bonnet, J-D Zeitoun
BACKGROUND: Anoperineal lesion (APL) occurrence is a significant event in the evolution of Crohn's disease (CD). Management should involve a multidisciplinary approach combining the knowledge of the gastroenterologist, the colorectal surgeon and the radiologist who have appropriate experience in this area. Given the low level of evidence of available medical and surgical strategies, the aim of this work was to establish a French expert consensus on management of anal Crohn's disease. These recommendations were led under the aegis of the Société Nationale Française de Colo-Proctologie (SNFCP)...
September 19, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28905225/the-feasibility-and-short-term-clinical-outcomes-of-single-incision-laparoscopic-surgery-for-patients-with-complex-crohn-s-disease
#2
Kiyoshi Maeda, Hisashi Nagahara, Masatsune Shibutani, Tatsunari Fukuoka, Shigetomi Nakao, Hirokazu Yamagami, Noriko Kamata, Kazuya Muguruma, Hiroaki Tanaka, Takahiro Toyokawa, Kosei Hirakawa, Masaichi Ohira
PURPOSE: Single-incision laparoscopic surgery (SILS) offers excellent cosmetic results compared with conventional multi-port laparoscopic surgery. Recently, this technique has been applied to Crohn's disease (CD) with primary ileocolic strictures; however, the application of a laparoscopic approach for complex CD, which involves abscess formation, fistula formation, and recurrent CD, is controversial. The aim of this study was to investigate the safety and feasibility of SILS for patients with complex disease and to compare its clinical results in patients with complex disease vs...
September 13, 2017: Surgery Today
https://www.readbyqxmd.com/read/28900730/review-of-local-injection-of-anti-tnf-for-perianal-fistulising-crohn-s-disease
#3
REVIEW
Samuel O Adegbola, Kapil Sahnan, Philip J Tozer, Robin Ks Phillips, Omar D Faiz, Janindra Warusavitarne, Ailsa Hart
BACKGROUND: Perianal fistulising Crohn's disease (PFCD) affects a third of Crohn's disease patients and represents a disabling phenotype with poor outcome. The anti-tumour necrosis factor alpha (TNF) therapies have been shown to maintain clinical remission in a third of patients after 1 year of treatment. Maintenance therapy with systematic administration schedules confers greatest benefit, but exposes patients to risks/side effects of continued systemic use and led to consideration of local drug delivery (first described in 2000)...
September 12, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28891851/sphincter-sparing-anal-fistula-repair-are-we-getting-better
#4
Jeremy Sugrue, Nathalie Mantilla, Ariane Abcarian, Kunal Kochar, Slawomir Marecik, Vivek Chaudhry, Anders Mellgren, Johan Nordenstam
BACKGROUND: Sphincter-sparing repairs are commonly used to treat anal fistulas with significant muscle involvement. OBJECTIVE: The current study evaluates the trends and efficacy of sphincter-sparing repairs and determines risk factors for fistula recurrence. DESIGN AND SETTINGS: A retrospective review was performed at 3 university-affiliated teaching hospitals. PATIENTS: All 462 patients with cryptoglandular anal fistulas who underwent 573 sphincter-sparing repairs between 2005 and 2015 were included...
October 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28888700/surgical-repair-of-rectovaginal-fistula-using-the-modified-martius-procedure-a-step-by-step-guide
#5
Dan Wang, Juan Chen, Lan Zhu, Mingchen Sang, Fan Yu, Qing Zhou
STUDY OBJECTIVE: to demonstrate the surgical repair of rectovaginal fistula by the modified Martius procedure. DESIGN: step by step presentation of the procedure using video. SETTING: Rectovaginal fistula (RVF) is abnormal epithelialized connections between the vagina and rectum. Causes of rectovaginal fistula include obstetrical trauma, Crohn disease, pelvic irradiation and postsurgical complications. Many surgical interventions have been developed, from laparoscopic technique to muscle transposition and even rectal resection...
September 6, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28885229/impact-of-diagnostic-delay-and-associated-factors-on-clinical-outcomes-in-a-u-s-inflammatory-bowel-disease-cohort
#6
Vu Q Nguyen, Dingfeng Jiang, Sharon N Hoffman, Srikar Guntaka, Jessica L Mays, Anthony Wang, Joseph Gomes, Dario Sorrentino
BACKGROUND: The impact of diagnostic delay in inflammatory bowel disease, including Crohn's disease (CD) and ulcerative colitis (UC), on disease course remains uncertain. This study examines factors that may influence time to diagnosis and disease outcomes in a U.S. patient cohort. METHODS: We retrospectively collected data on patient characteristics, time to diagnosis, disease phenotype, and complications in 177 patients with inflammatory bowel disease (110 CD and 67 UC) diagnosed at our institution from 2008 to 2015...
September 6, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28882770/video-assisted-anal-fistula-treatment-vaaft-in-cryptoglandular-fistula-in-ano-a-systematic-review-and-proportional-meta-analysis
#7
REVIEW
Pankaj Garg, Pratiksha Singh
BACKGROUND: Video-Assisted Anal Fistula Treatment (VAAFT) is a relatively new minimally invasive videoendoscopic procedure for treating fistula-in-ano. We reviewed and performed metaanalysis to evaluate the efficacy of this procedure. METHODS: Studies from the period 2010 to 2016 were searched in PubMed, Medline, Scopus, Embase, Ovid, SCI database, Cochrane Central Register of Controlled Trials (CENTRAL) & Google Scholar database. All studies which utilized VAAFT to treat fistula-in-ano were extracted...
September 4, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28858069/comparison-of-health-care-utilization-and-costs-between-patients-with-perianal-fistulizing-crohn-s-disease-treated-with-biologics-with-or-without-previous-seton-placement
#8
David A Schwartz, Anthony Wang, Burak Ozbay, Martha Skup, Samantha F Eichner, Jay Lin, Jingdong Chao
BACKGROUND: Fistulas are a common and often debilitating complication of Crohn's disease (CD). Tumor necrosis factor inhibitors and/or seton drainage are effective treatment options. We compared health care utilization and costs for patients with perianal CD who had setons placed before treatment with biologics versus those who did not. METHODS: Patients with CD (≥18 yr) were identified from the Truven Health MarketScan Database by ICD-9 code 555.x (January 1, 2006-March 31, 2015); those with external fistulas were identified by ICD-9 codes 565...
August 29, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28857130/natural-history-of-anorectal-sepsis
#9
K Sahnan, A Askari, S O Adegbola, P J Tozer, R K S Phillips, A Hart, O D Faiz
BACKGROUND: Progression from anorectal abscess to fistula is poorly described and it remains unclear which patients develop a fistula following an abscess. The aim was to assess the burden of anorectal abscess and to identify risk factors for subsequent fistula formation. METHODS: The Hospital Episode Statistics database was used to identify all patients presenting with new anorectal abscesses. Cox regression analysis was undertaken to identify factors predictive of fistula formation...
August 31, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28854988/-changes-in-the-treatment-of-crohn-s-disease-fewer-hospitalizations-less-surgery-and-reduced-glucocorticoid-use
#10
S F G Jeuring, T R A van den Heuvel, M P Zeegers, J J Haans, M J L Romberg-Camps, L E Oostenbrug, L P S Stassen, A A M Masclee, D M A E Jonkers, M J Pierik
OBJECTIVE: To study changes in treatment and disease course in patients with Crohn's disease (CD) in the South Limburg region of the Netherlands between 1991 and 2014. DESIGN: Population-based cohort study. METHODS: All 1162 CD patients in the 'IBD South Limburg cohort' were divided across three subcohorts on the basis of year of diagnosis: 1991-1998 (N = 316), 1999-2005 (N = 387) and 2006-2011 (N = 459). We compared the risk of hospitalization, bowel resection and the development of strictures and/or fistulas across the subcohorts...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28851611/the-efficacy-of-infliximab-combined-with-surgical-treatment-of-fistulizing-perianal-crohn-s-disease-comparative-analysis-according-to-fistula-subtypes
#11
Eun Jung Park, Ki-Hwan Song, Seung Hyuk Baik, Jae Jun Park, Jeonghyun Kang, Kang Young Lee, Ja Il Goo, Nam Kyu Kim
BACKGROUND/OBJECTIVE: Infliximab is regarded as an effective therapeutic to treat Crohn's disease. This study aimed to assess the efficacy of infliximab combined with surgery and to analyze clinical manifestations according to fistula subtypes in patients with fistulizing perianal Crohn's disease. METHODS: From April 2013 to December 2015, 47 patients with perianal Crohn's disease in two hospitals of South Korea (Goo Hospital, Gangnam Severance Hospital) were evaluated retrospectively...
August 26, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28839437/elaboration-and-validation-of-crohn-s-disease-anoperineal-lesions-consensual-definitions
#12
Clémence Horaist, Vincent de Parades, Laurent Abramowitz, Paul Benfredj, Guillaume Bonnaud, Dominique Bouchard, Nadia Fathallah, Agnès Sénéjoux, Laurent Siproudhis, Ghislain Staumont, Manuelle Viguier, Philippe Marteau
AIM: To establish consensual definitions of anoperineal lesions of Crohn's (APLOC) disease and assess interobserver agreement on their diagnosis between experts. METHODS: A database of digitally recorded pictures of APLOC was examined by a coordinating group who selected two series of 20 pictures illustrating the various aspects of APLOC. A reading group comprised: eight experts from the Société Nationale Française de Colo Proctologie group of study and research in proctology and one academic dermatologist...
August 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28838644/laparoscopic-ileocaecal-resection-versus-infliximab-for-terminal-ileitis-in-crohn-s-disease-a-randomised-controlled-open-label-multicentre-trial
#13
Cyriel Y Ponsioen, E Joline de Groof, Emma J Eshuis, Tjibbe J Gardenbroek, Patrick M M Bossuyt, Ailsa Hart, Janindra Warusavitarne, Christianne J Buskens, Ad A van Bodegraven, Menno A Brink, Esther C J Consten, Bart A van Wagensveld, Marno C M Rijk, Rogier M P H Crolla, Casper G Noomen, Alexander P J Houdijk, Rosalie C Mallant, Maarten Boom, Willem A Marsman, Hein B Stockmann, Bregje Mol, A Jeroen de Groof, Pieter C Stokkers, Geert R D'Haens, Willem A Bemelman
BACKGROUND: Treatment of patients with ileocaecal Crohn's disease who have not responded to conventional therapy is commonly scaled up to biological agents, but surgery can also offer excellent short-term and long-term results. We compared laparoscopic ileocaecal resection with infliximab to assess how they affect health-related quality of life. METHODS: In this randomised controlled, open-label trial, in 29 teaching hospitals and tertiary care centres in the Netherlands and the UK, adults with non-stricturing, ileocaecal Crohn's disease, in whom conventional therapy has failed were randomly allocated (1:1) by an internet randomisation module with biased-coin minimisation for participating centres and perianal fistula to receive laparoscopic ileocaecal resection or infliximab...
August 21, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28838421/the-evolution-of-treatment-paradigms-in-crohn-s-disease-beyond-better-drugs
#14
REVIEW
Reena Khanna, Vipul Jairath, Brian G Feagan
Despite advances in care, most patients with Crohn's disease (CD) develop complications, such as fistulas, or require surgery. Given the recent advances in drug therapy, an opportunity exists to optimize the management of this chronic disease through early use of effective therapies, clear definition of treatment targets, and application of the principles of personalized medicine. In this article, the authors discuss the evolution of treatment algorithms for CD to incorporate these strategies.
September 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28818730/enterohepatic-fistula-in-a-crohn-s-disease-patient-a-case-report
#15
Justin T Van Backer, Edward C Lee
INTRODUCTION: Fistulous tracts are a hallmark of Crohn's Disease. However, solid organ to intestinal fistulas are rare with previously few case reports of colosplenic fistulas and one case report of an enterohepatic fistula. PRESENTATION OF CASE: We review the available literature and present the first case report of an enterohepatic fistula in a female with Crohn's Disease to be treated operatively. The patient did well postoperatively with complete resolution of her fistula...
August 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28790453/perianal-fistulizing-crohn-s-disease-pathogenesis-diagnosis-and-therapy
#16
REVIEW
Julián Panés, Jordi Rimola
Perianal fistulizing Crohn's disease has a major negative effect on patient quality of life and is a predictor of poor long-term outcomes. Factors involved in the pathogenesis of perianal fistulizing Crohn's disease include an increased production of transforming growth factor β, TNF and IL-13 in the inflammatory infiltrate that induce epithelial-to-mesenchymal transition and upregulation of matrix metalloproteinases, leading to tissue remodelling and fistula formation. Care of patients with perianal Crohn's disease requires a multidisciplinary approach...
August 9, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28738237/a-case-report-of-unexpected-pathology-within-an-incarcerated-ventral-hernia
#17
Erica D Kane, Katharine R Bittner, Michelle Bennett, John R Romanelli, Neal E Seymour, Jacqueline J Wu
INTRODUCTION: Incidence of hernial appendicitis is 0.008%, most frequently within inguinal and femoral hernias. Up to 2.5% of appendectomy patients are found to have Crohn's disease. Elucidating the etiology of inflammation is essential for directing management. PRESENTATION OF CASE: A 51-year-old female with achondroplastic dwarfism, multiple cesarean sections, and subsequent massive incisional hernia, presented with ruptured appendicitis within her incarcerated hernia...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28732299/enterovesical-fistula-a-rare-complication-of-meckel-s-diverticulum-a-case-report
#18
Bourguiba M A, Gharbi M, Ghalleb M, Ben Taher A, Souai F, Bensafta Y, Sayari S, Ben Moussa M
INTRODUCTION: Enterovesical fistulas usually result from diverticulitis, Crohn's disease, or colorectal cancer. A perforated Meckel's diverticulum can exceptionally result in an vesico-diverticulum fistula, as noted in only seven previously reported cases. CASE REPORT: A 35-year old Arabic male, quadriplegic,who presented epigastralgia evolving for a week, associated with abdominal distension and cloudy urine. On examination he was feverish (38.5°C), dehydrated with tenderness in the entire distended abdomen; rectal examination revealed a hypotonic sphincter with no other abnormality...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28703786/fistulizing-crohn-s-disease
#19
Michael Scharl, Gerhard Rogler, Luc Biedermann
Fistulas still represent one of the most important complications in patients with Crohn's disease (CD). At least one third of CD patients suffer from fistulas during their disease course and amongst them longstanding remission of complex fistulas occurs only in about one third. So far, fistula pathogenesis is only partially understood. From a histopathological view, a fistula is a tube covered by flat epithelial cells. Current research suggests that the driving force for fistula development is epithelial-to-mesenchymal transition (EMT)...
July 13, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28701261/five-year-survival-and-causes-of-death-in-patients-on-home-parenteral-nutrition-for-severe-chronic-and-benign-intestinal-failure
#20
Francisca Joly, Janet Baxter, Michael Staun, Darlene G Kelly, Yi Lisa Hwa, Olivier Corcos, Antonella De Francesco, Federica Agostini, Stanislaw Klek, Lidia Santarpia, Franco Contaldo, Cora Jonker, Geert Wanten, Luisa Chicharro, Rosa Burgos, Andre Van Gossum, Cristina Cuerda, Nuria Virgili, Loris Pironi
BACKGROUND & AIM: Home parenteral nutrition (HPN) is the primary treatment for chronic intestinal failure (IF). Intestinal transplantation (ITx) is indicated when there is an increased risk of death due to HPN complications or to the underlying disease. Age, pathophysiologic conditions and underlying disease are known predictors of HPN dependency and overall survival. Although the cause of death on HPN is mostly related to underlying disease in these patients, the relationship between mortality and duration of HPN use remains unclear...
June 19, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
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