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Crohn fistula

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https://www.readbyqxmd.com/read/28818730/enterohepatic-fistula-in-a-crohn-s-disease-patient-a-case-report
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28694669/magnetic-resonance-imaging-may-predict-deep-remission-in-patients-with-perianal-fistulizing-crohn-s-disease
#7
Lucie Thomassin, Laura Armengol-Debeir, Cloé Charpentier, Valerie Bridoux, Edith Koning, Guillaume Savoye, Céline Savoye-Collet
AIM: To evaluate the imaging course of Crohn's disease (CD) patients with perianal fistulas on long-term maintenance anti-tumor necrosis factor (TNF)-α therapy and identify predictors of deep remission. METHODS: All patients with perianal CD treated with anti-TNF-α therapy at our tertiary care center were evaluated by magnetic resonance imaging (MRI) and clinical assessment. Two MR examinations were performed: at initiation of anti-TNF-α treatment and then at least 2 years after...
June 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28693839/outcome-of-incisional-hernia-repair-in-patients-with-inflammatory-bowel-disease
#8
Tomas M Heimann, Santosh Swaminathan, Adrian J Greenstein, Alexander J Greenstein, Randolph M Steinhagen
BACKGROUND: Incisional Hernia (IH) repair in patients with Inflammatory Bowel Disease (IBD) has not been well studied. METHODS: Outcomes of 170 patients with IBD who underwent IH repair were included in the study. RESULTS: The incidence of recurrence after IH repair in IBD is 27%. Patients with Crohn's disease (CD) had larger defects at the time of repair, higher proportion of bowel resection and a longer postoperative stay when compared to Ulcerative colitis (UC)...
June 7, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28690491/a-complicated-thread-abdominal-actinomycosis-in-a-young-woman-with-crohn-disease
#9
Ari Nahum, Gregory Filice, Ashish Malhotra
Crohn disease is a chronic inflammatory condition that primarily affects the gastrointestinal tract. Typical manifestations include fever, weight loss, fatigue, and abdominal pain, and abdominal abscesses and fistulae are frequent complications. Abdominal actinomycosis is a subacute or indolent disease associated with Actinomyces spp. Symptoms can be very similar to those of Crohn disease, and fistulae are also common. Since ulcerations in the intestinal tract are thought to be caused by Actinomyces escaping from the gut lumen and establishing intra-abdominal infection, it seems likely that abdominal actinomycosis may occur in patients with inflammatory bowel disease...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28662984/mr-enterography-in-crohn-s-disease-complicated-with-enteroenteric-fistula
#10
Ayşe Erden, Sena Ünal, Habip Eser Akkaya, Mehmet Onay, Murat Törüner, Zeynep Bıyıklı Gençtürk, Aysun Çalışkan Kartal
OBJECTIVE: In this retrospective study, we aimed to evaluate MR enterography (MRE) findings, MR index of activity (MaRIA) and laboratory markers in Crohn patients with enteroenteric fistula. METHODS: Institution's electronic medical records (laboratory, pathology, ileocolonoscopy results and discharge summary) were reviewed and MR images retrieved from the PACS were reanalyzed in Crohn patients assessed at Gastroenterology Clinic of our university between July 2011 and July 2016...
June 20, 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28653753/the-development-of-a-magnetic-resonance-imaging-index-for-fistulising-crohn-s-disease
#11
M A Samaan, C A J Puylaert, B G Levesque, G Y Zou, L Stitt, S A Taylor, L M Shackelton, M K Vandervoort, R Khanna, C Santillan, J Rimola, P Hindryckx, C Y Nio, W J Sandborn, G D'Haens, B G Feagan, V Jairath, J Stoker
BACKGROUND: Magnetic resonance imaging (MRI) is the gold standard for assessment of perianal fistulising Crohn's disease (CD). The Van Assche index is the most commonly used MRI fistula index. AIMS: To assess the reliability of the Van Assche index, and to modify the instrument to improve reliability and create a novel index for fistulising CD. METHODS: A consensus process developed scoring conventions for existing Van Assche index component items and new items...
June 27, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28643034/assessing-internet-based-information-used-to-aid-patient-decision-making-about-surgery-for-perianal-crohn-s-fistula
#12
J H Marshall, D M Baker, M J Lee, G L Jones, A J Lobo, S R Brown
BACKGROUND: Decision-making in perianal Crohn's fistula (pCD) is preference sensitive. Patients use the internet to access healthcare information. The aim of this study was to assess the online information and patient decision aids relating to surgery for pCD. METHODS: A search of Google™ and the Decision Aids Library Inventory (DALI) was performed using a predefined search strategy. Patient-focussed sources providing information about pCD surgery were included in the analysis...
June 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28642788/comparison-between-intestinal-beh%C3%A3-et-s-disease-and-crohn-s-disease-in-characteristics-of-symptom-endoscopy-and-radiology
#13
Tianyu Zhang, Liwen Hong, Zhengting Wang, Rong Fan, Maochen Zhang, Yun Lin, Mengmeng Cheng, Xiaolin Zhou, Peijun Sun, Xiaoyi Lin, Jie Zhong
AIM: To evaluate different parameters in differentiating intestinal BD from CD. METHODS: The medical records of inpatients with intestinal BD and CD were retrospectively reviewed. The univariate value of different parameters was analyzed, respectively. A differentiation model was established by pooling all valuable parameters together. Diagnostic efficacy was evaluated, and a receiver operating curve (ROC) was plotted. RESULTS: Forty-two BD patients and ninety-seven CD patients were reviewed...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28639073/prognostic-factors-affecting-outcomes-in-fistulating-perianal-crohn-s-disease-a-systematic-review
#14
REVIEW
G C Braithwaite, M J Lee, D Hind, S R Brown
BACKGROUND: One in three patients with Crohn's disease will develop a perianal fistulae, and one third of these will achieve long-term healing or closure. A barrier to conducting well-designed clinical trials for these patients is a lack of understanding of prognostic factors. This systematic review sets out to identify factors associated with prognosis of perianal Crohn's fistulae. METHODS: This review was registered on the PROSPERO database (CRD42016050316) and conducted in line with PRISMA guidelines along a predefined protocol...
June 20, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28633544/medical-versus-surgical-management-of-penetrating-crohn-s-disease-the-current-situation-and-future-perspectives
#15
Seema A Patil, Raymond K Cross
The development of penetrating Crohn's disease (CD) occurs in up to 50% of patients over the course of their lifetime. While the presentation of these complications, including free perforation, intra-abdominal abscess, and enteric fistula, are usually obvious, the management can require a nuanced approach, with distinct short and long-term approaches. Areas covered: This review discusses medical and surgical methods of treating these complications, including the role of percutaneous drainage of abscesses, the implications of a stricture associated with a fistula, and the efficacy of postoperative anti-TNF therapy in preventing recurrence after surgical treatment...
June 21, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28620877/pathogenesis-and-persistence-of-cryptoglandular-anal-fistula-a-systematic-review
#16
REVIEW
Jeremy Sugrue, Johan Nordenstam, Herand Abcarian, Amelia Bartholomew, Joel L Schwartz, Anders Mellgren, Philip J Tozer
Anal fistulas continue to be a problem for patients and surgeons alike despite scientific advances. While patient and anatomical characteristics are important to surgeons who are evaluating patients with anal fistulas, their development and persistence likely involves a multifaceted interaction of histological, microbiological, and molecular factors. Histological studies have shown that anal fistulas are variably epithelialized and are surrounded by dense collagen tissue with pockets of inflammatory cells. Yet, it remains unknown if or how histological differences impact fistula healing...
June 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28604511/incidence-and-risk-factors-for-perianal-disease-in-pediatric-crohn-s-disease-patients-followed-in-cedata-gpge-registry
#17
Annecarin Brückner, Katharina J Werkstetter, Jan de Laffolie, Claudia Wendt, Christine Prell, Tanja Weidenhausen, Klaus P Zimmer, Sibylle Koletzko
BACKGROUND AND AIMS: Perianal disease (PD) with fistula and/or abscess formation is a severe complication in Crohn's disease (CD). We examined prevalence, incidence and risk factors for PD development in a pediatric CD cohort. METHODS: CD patients from the prospective, multi-center registry for inflammatory bowel disease from Germany and Austria (CEDATA-GPGE) were included if diagnosed ≤18 years of age, registered within three months after diagnosis, and having at least two follow-up visits within the first year of registration...
June 9, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28598298/efficacy-of-exclusive-enteral-nutrition-in-complicated-crohn-s-disease
#18
Qingfan Yang, Xiang Gao, Huiping Chen, Miao Li, Xiaojian Wu, Min Zhi, Ping Lan, Pinjin Hu
AIM: To investigate the efficacy of exclusive enteral nutrition (EEN) in induction of remission in adult active Crohn's disease (CD) complicated with intestinal fistula/abdominal abscess or inflammatory intestinal stricture. METHOD: Patients diagnosed with active CD with complications were recruited between July 2013 and July 2015. Patients were offered EEN for 12 weeks. Patients with abscess received antibiotic treatment with or without percutaneous drainage. Clinical variables were recorded (ClinicalTrials...
September 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28597827/inflammatory-bowel-disease-in-childhood-and-adolescence
#19
Jan Däbritz, Patrick Gerner, Axel Enninger, Martin Claßen, Michael Radke
BACKGROUND: The incidence of inflammatory bowel disease (IBD) in childhood and adolescence is 5-11 cases per 100 000 persons per year, corresponding to a new diagnosis of IBD in 800-1470 patients in Germany each year. METHODS: This review is based on pertinent publications retrieved by a selective search in PubMed, including guidelines from Germany and abroad. RESULTS: Children and adolescents with IBD often have extensive involvement and an aggressive course of disease...
May 12, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28583202/systematic-review-with-meta-analysis-the-efficacy-and-safety-of-stem-cell-therapy-for-crohn-s-disease
#20
REVIEW
Yun Qiu, Man-Ying Li, Ting Feng, Rui Feng, Ren Mao, Bai-Li Chen, Yao He, Zhi-Rong Zeng, Sheng-Hong Zhang, Min-Hu Chen
BACKGROUND AND AIMS: Stem cell therapy (SCT) for the treatment of Crohn's disease (CD) is still in its infancy, and whether SCT is associated with improved outcomes is unclear. We performed a meta-analysis to evaluate the efficacy and safety of patients receiving SCT. METHODS: Electronic databases were searched for studies that reported the use of stem cells for the treatment of patients with CD. Raw data from included studies were pooled for effect estimates. Subgroup analyses were performed for exploration of heterogeneity regarding all outcomes...
June 6, 2017: Stem Cell Research & Therapy
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