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Crohn fistula

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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
#1
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
#2
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
#3
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
#4
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...
November 14, 2017: Drugs
https://www.readbyqxmd.com/read/29135086/can-mr-enterography-screen-for-perianal-disease-in-pediatric-inflammatory-bowel-disease
#5
Zehour AlSabban, Nicholas Carman, Rahim Moineddin, Ryan T Lo, Sebastian K King, Jacob C Langer, Thomas D Walters, Anne M Griffiths, Peter C Church, Mary-Louise C Greer
BACKGROUND: Pediatric Crohn's disease is associated with perianal disease (PAD). Magnetic resonance enterography (MRE) assesses small bowel involvement in pediatric inflammatory bowel disease (PIBD). Pelvic MRI (P-MRI) is the gold standard for assessing PAD. PURPOSE: To determine if MRE can accurately detect PAD in PIBD, distinguishing perianal fistulae (PAF) from perianal abscesses (PAA), referenced against P-MRI. STUDY TYPE: Retrospective...
November 14, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29084079/real-world-experience-of-anti-tumor-necrosis-factor-therapy-for-internal-fistulas-in-crohn-s-disease-a-retrospective-multicenter-cohort-study
#6
Taku Kobayashi, Asahi Hishida, Hiroki Tanaka, Yoichiro Nuki, Shigeki Bamba, Akihiro Yamada, Toshimitsu Fujii, Shinichiro Shinzaki, Yoko Yokoyama, Atsushi Yoshida, Keiji Ozeki, Shinya Ashizuka, Noriko Kamata, Sohachi Nanjo, Kazuki Kakimoto, Misaki Nakamura, Akira Matsui, Ryosuke Yamauchi, Sakuma Takahashi, Taku Tomizawa, Takuya Yoshino, Toshifumi Hibi
BACKGROUND: Internal fistula in Crohn's disease is a condition likely to require surgery, although few reports showed successful medical treatments such as anti-tumor necrosis factor (TNF) therapy. We performed a multicenter retrospective cohort study to investigate the outcome of anti-TNF therapy for internal fistula in Crohn's disease. METHODS: Data were retrospectively collected from patients with Crohn's disease diagnosed with internal fistula treated with anti-TNF agents (infliximab or adalimumab) between January 2002 and November 2015...
December 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29075825/effective-communication-of-cross-sectional-imaging-findings-in-crohn-s-disease-comparing-conventional-emr-reporting-to-a-published-scoring-system
#7
Andrew Flint, Naueen A Chaudhry, Michael Riverso, Angela Pham, Patricia P Moser, Lazarus K Mramba, Ellen M Zimmermann, Joseph R Grajo
PURPOSE: The purpose of the article is to compare information regarding small bowel lesions in Crohn's disease (CD) patients communicated by a published scoring system and radiology reports from electronic medical record (EMR) of cross-sectional abdominal imaging. METHODS: Two gastrointestinal radiologists (reference readers) blinded to EMR reports scored cross-sectional imaging exams using a published scoring system. Investigators compared EMR and radiologist scores based on the mentioned findings and severity documentation of each variable...
October 26, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29052254/genetic-polymorphisms-associated-with-smoking-behaviour-predict-the-risk-of-surgery-in-patients-with-crohn-s-disease
#8
B M Lang, L Biedermann, W T van Haaften, C de Vallière, M Schuurmans, S Begré, J Zeitz, M Scharl, M Turina, T Greuter, P Schreiner, H Heinrich, T Kuntzen, S R Vavricka, G Rogler, N Beerenwinkel, B Misselwitz
BACKGROUND: Smoking is a strong environmental factor leading to adverse outcomes in Crohn's disease, but a more benign course in ulcerative colitis. Several single nucleotide polymorphisms (SNPs) are associated with smoking quantity and behaviour. AIMS: To assess whether smoking-associated SNPs interact with smoking to influence the clinical course of inflammatory bowel diseases. METHODS: Genetic and prospectively obtained clinical data from 1434 Swiss inflammatory bowel disease cohort patients (821 Crohn's disease and 613 ulcerative colitis) were analysed...
October 20, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29046093/video-assisted-anal-fistula-treatment-a-high-volume-unit-initial-experience
#9
F Y Cheung, N D Appleton, S Rout, R Kalaiselvan, J A Nicholson, A Samad, M Chadwick, R Rajaganeshan
Introduction Perianal fistulas are a common problem. Video-assisted anal fistula treatment is a new technique for the management of this difficult condition. We describe our initial experience with the technique to facilitate the treatment of established perianal fistulas. Methods We reviewed a prospectively maintained database relating to consecutive patients undergoing video-assisted anal fistula treatment in a single unit. Results Seventy-eight consecutive patients had their perianal fistulas treated with video-assistance from November 2014 to June 2016...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29037747/advancement-flap-technique-for-anal-fistula-in-patients-with-crohn-s-disease-a-systematic-review-of-the-literature
#10
Virginia Rozalén, David Parés, Edward Sanchez, José Troya, Sandra Vela, Miguel Ángel Pacha, Marta Piñol, Joan-Francesc Julián
INTRODUCTION: Treatment for anal fistulas in patients with Crohn's disease is still challenging, even for the expert surgeon. The advancement flap technique is characterized by the preservation of the anal sphincter complex. METHODS: A systematic review of the literature, selecting series of patients affected by Crohn's disease and anal fistulas and treated using advancement flap technique was performed. Patients followed during at least 6 months have been included...
October 13, 2017: Cirugía Española
https://www.readbyqxmd.com/read/29028958/development-of-clinical-prediction-models-for-surgery-and-complications-in-crohn-s-disease
#11
Leonardo Guizzetti, Guangyong Zou, Reena Khanna, Parambir S Dulai, William J Sandborn, Vipul Jairath, Brian G Feagan
Background and Aims: Crohn's disease-related complications account for a substantial proportion of inflammatory bowel disease-associated healthcare expenditure. Identifying patients at risk for complications may allow for targeted use of early therapeutic interventions to off-set this natural course. We aimed to develop risk prediction models for Crohn's disease-related surgery and complications. Methods: Using data from the Randomized Evaluation of an Algorithm for Crohn's Disease cluster-randomized clinical Trial (REACT), which involved 1898 patients from 40 community practices...
September 19, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29026838/tumor-necrosis-factor-alpha-antibodies-in-fistulizing-crohn-s-disease-an-updated-systematic-review-and-meta-analysis
#12
REVIEW
Pardis Zaboli, Mohammad Abdollahi, Shilan Mozaffari, Shekoufeh Nikfar
Medical treatment for fistulizing Crohn's disease (FCD) is changing rapidly over the time by the introduction of novel therapeutic medicines, while no global consensus is available. This study aims to accomplish a systematic review and meta-analysis on the efficacy of tumor necrosis factor-alpha antibodies (anti-TNF-α antibodies) versus placebo in FCD. A systematic review of published literature was carried out till December 2016, and a meta-analysis of identified studies was done. Data have been explored from PubMed, Scopus, Cochrane Library Database, and Web of Science...
July 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/29017689/peristomal-lesions-in-crohn-s-disease-are-they-always-fistulae
#13
Holger Schäffler, Georg Lamprecht, Maria Witte
No abstract text is available yet for this article.
September 22, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28981618/in-patients-with-perianal-crohn-s-fistulas-what-are-the-outcomes-when-radiological-healing-is-achieved-does-radiological-healing-of-perianal-crohn-s-fistulas-herald-the-time-point-for-stopping-a-biologic
#14
https://www.readbyqxmd.com/read/28979892/the-adjunctive-role-of-nutritional-therapy-in-the-management-of-phlegmon-in-two-children-with-crohn-s-disease
#15
Andrew S Day, Stephanie C Brown
Crohn's disease may be complicated by the development of penetrating (fistulizing) or structuring complications. The presentation of an intra-abdominal phlegmon or abscess with or without an associated fistula has traditionally required surgical intervention. This series of two cases illustrates a beneficial role of non-surgical management, with parenteral and then enteral nutrition playing central roles. This report further elaborates the potential adjunctive role of enteral nutrition in the management of this complication of CD...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28974897/temporal-trends-in-the-misdiagnosis-rates-between-crohn-s-disease-and-intestinal-tuberculosis
#16
Hyungil Seo, Seohyun Lee, Hoonsub So, Donghoi Kim, Seon-Ok Kim, Jae Seung Soh, Jung Ho Bae, Sun-Ho Lee, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Byong Duk Ye
AIM: To investigate the temporal trends in the misdiagnosis rate between Crohn's disease (CD) and intestinal tuberculosis (ITB) in South Korea. METHODS: We retrospectively reviewed the medical records of patients managed for CD or ITB at Asan Medical Center, a tertiary referral hospital, Seoul, Korea between 1996 and 2014. The temporal trends in the misdiagnosis rates between the two diseases were analyzed. The demographic and clinical characteristics were compared between CD patients who were initially misdiagnosed as ITB (final CD group) and vice versa (final ITB group)...
September 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28974885/defining-and-predicting-deep-remission-in-patients-with-perianal-fistulizing-crohn-s-disease-on-anti-tumor-necrosis-factor-therapy
#17
EDITORIAL
Konstantinos Papamichael, Adam S Cheifetz
Perianal fistulas can occur to up to one-third of patients with Crohn's disease (CD) leading to significant disabling disease and morbidity. Fistulising perianal CD treatment often necessitates a combined pharmacological and surgical approach. Anti-tumor necrosis factor (anti-TNF) therapy, particularly infliximab, has been shown to be very effective for both perianal and internal fistulising CD. Nevertheless, current data suggest that sustained remission and long-term complete fistula healing can be achieved in only 30% to 50% of patients...
September 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28963700/enterocutaneous-fistulas-a-primer-for-radiologists-with-emphasis-on-ct-and-mri
#18
REVIEW
Massimo Tonolini, Paolo Magistrelli
Enterocutaneous fistulas (ECFs) represent abnormal communications between the gastrointestinal tract and the skin. Nowadays, the majority (~80%) of ECFs develops secondary to abdominal surgeries; alternative, less common causes include chronic inflammatory bowel diseases (IBD) such as Crohn's disease, tumours, and radiation enteritis in descending order of frequency. These rare disorders require thorough patient assessment and multidisciplinary management to limit the associated morbidity and mortality. This pictorial review includes an overview of causes, clinical manifestations, complications and management of ECFs...
September 29, 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/28953535/comparison-of-transperianal-ultrasound-with-colonoscopy-and-magnetic-resonance-imaging-in-perianal-crohn-s-disease
#19
Eun Hye Lee, Hye Ran Yang, Ji Young Kim
OBJECTIVES: Perianal fistulae and/or abscesses are common complications of Crohn's disease (CD), especially in children. Magnetic resonance imaging (MRI) and gross examination under anesthesia are accurate diagnostic modalities for evaluating perianal lesions. However, both methods are expensive and have some limitations for use in children. This study aims to assess the accuracy of transperianal ultrasound (TPUS) and colonoscopic examination, compared with MRI, in pediatric patients with perianal CD (PACD)...
September 26, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28945635/comparison-of-stromal-vascular-fraction-with-or-without-a-novel-bioscaffold-to-fibrin-glue-in-a-porcine-model-of-mechanically-induced-anorectal-fistula
#20
Gerald W Dryden, Eugene Boland, Vijay Yajnik, Stuart Williams
BACKGROUND: Anorectal fistulas (ARFs) are a common, devastating, event in the life of a patient with Crohn's disease. ARFs occur in up to 50% of patients with Crohn's disease. Treatment begins with surgical drainage of the initial abscess, followed by antibiotic therapy, then anti-inflammatory medications. If medical therapy fails to close the fistula tract, surgical intervention is often pursued. Surgery incurs risk of incontinence because of sphincter injury. Increasingly, the role of cell-based therapy is being investigated in ARFs...
November 2017: Inflammatory Bowel Diseases
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