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https://www.readbyqxmd.com/read/28401051/surgery-in-pediatric-crohn-s-disease-indications-timing-and-post-operative-management
#1
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/28399604/transperineal-ultrasound-for-perianal-fistulas-and-abscesses-a-systematic-review-and-meta-analysis
#2
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/28381141/rare-inverted-verrucous-carcinoma-carcinoma-cuniculatum-of-the-sacrogluteal-region
#3
David John Tobias McArdle, John Patrick McArdle, Frances Lee, Emilio Dino Mignanelli
A 49-year-old woman with a past history of several infundibular cysts in the head and neck region presented with a 6-month history of a nonhealing perianal abscess on a background of 13 years of chronic sacral-buttock abscesses and discharging sinuses as part of hidradenitis suppurativa. After 2 surgical procedures and inadequate healing, a wide local excision was performed. The surgical specimen revealed an extensive, infiltrating, cystic and deeply penetrating, dermal and subcutaneous neoplasm with multiple fistulous tracts extending to the skin surface...
February 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28319427/new-horizons-in-the-imaging-of-perianal-crohn-s-disease-transperineal-ultrasonography
#4
Cristina Bezzio, Robert V Bryant, Gianpiero Manes, Giovanni Maconi, Simone Saibeni
Perianal disease, most commonly manifest as fistula or abscess formation, affects up to 40% of patients with Crohn's disease. Perianal Crohn's disease is disabling, associated with poor outcomes, and represents a therapeutic challenge for physicians. Correct diagnosis and classification of perianal disease is the first crucial step for appropriate multidisciplinary management. Areas covered: A literature search was performed of the PubMed database using the terms "transperineal ultrasonography", "transperineal ultrasound", "perianal disease", "perianal fistula", "perianal abscess", "magnetic resonance", "endoanal ultrasonography", "endoscopic ultrasound" in combination with "Crohn's disease"...
March 20, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28267044/mutations-in-interleukin-10-receptor-and-clinical-phenotypes-in-patients-with-very-early-onset-inflammatory-bowel-disease-a-chinese-veo-ibd-collaboration-group-survey
#5
Zhiheng Huang, Kaiyue Peng, Xiaoqin Li, Ruiqin Zhao, Jieyu You, Xiuyong Cheng, Zhaoxia Wang, Ying Wang, Bingbing Wu, Huijun Wang, Huasong Zeng, Zhuowen Yu, Cuifang Zheng, Yuesheng Wang, Ying Huang
BACKGROUND: Interleukin-10 (IL10) signaling plays an important role in the pathogenesis of very early onset inflammatory bowel disease (VEO-IBD) in children. However, little is known about the role of the IL10 axis in children with VEO-IBD in China. METHODS: The Chinese VEO-IBD Collaboration Group was created to collect clinical and genetic data from patients deficient in IL10 and the IL10 receptor. High-throughput sequencing was performed to identify mutations in these genes...
April 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28256718/lipocalin-2-is-expressed-by-activated-granulocytes-and-keratinocytes-in-affected-skin-and-reflects-disease-activity-in-acne-inversa-hidradenitis-suppurativa
#6
K Wolk, J Wenzel, A Tsaousi, E Witte-Händel, N Babel, C Zelenak, H-D Volk, W Sterry, S Schneider-Burrus, R Sabat
BACKGROUND: Acne inversa (AI)/Hidradenitis suppurativa is a chronic inflammatory disease characterized by painful axillary, inguinal, and perianal skin lesions with deep-seated nodules, abscesses, and fistulae. OBJECTIVES: This study aimed at the identification and characterization of key players in AI pathogenesis. METHODS: Epidemiologic and anamnestic data as well as blood and skin samples of AI patients were collected. Healthy participants and psoriasis patients served as controls...
March 3, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28255623/anal-canal-duplication-and-triplication-a-rare-entity-with-different-presentations
#7
P Palazon, V Julia, L Saura, I de Haro, M Bejarano, C Rovira, X Tarrado
Anal canal duplication (ACD) is the rarest of gastrointestinal duplications. Few cases have been reported. Most cases present as an opening in the midline, posterior to the normal anus. The aim of our revision is to contribute with eight new cases, some of them with unusual presentations: five presented as the typical form, one with a perianal nodule, and two presented as two separate orifices (anal canal triplication). Complete excision was performed in all patients with no complications. ACD is the most distal and the least frequent digestive duplication...
May 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28229030/retroperitoneal-necrotizing-fasciitis-masquerading-as-perianal-abscess-rare-and-perilous
#8
Anandhi Amaranathan, Ashok Kumar Sahoo, Deepak Barathi, Gomathi Shankar, Sarath Chandra Sistla
Necrotizing fasciitis is one of the uncommon presentations of a rapidly spreading subcutaneous tissue infection. Although the actual cause is unclear in many cases, most of them are due to the rapid proliferation of microorganisms. Retroperitoneal necrotizing fasciitis is extremely rare. It is a potentially lethal infection that requires immediate and aggressive surgical care. Early diagnosis is the key to a better prognosis. The possibility of retroperitoneal necrotizing fasciitis should be suspected in patients with symptoms of sepsis that are disproportionate to clinical findings...
January 17, 2017: Curēus
https://www.readbyqxmd.com/read/28223268/perianal-abscess
#9
REVIEW
Kapil Sahnan, Samuel O Adegbola, Phillip J Tozer, Josef Watfah, Robin Ks Phillips
No abstract text is available yet for this article.
February 21, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28216137/low-predictive-value-of-histopathological-scoring-system-for-complications-development-in-children-with-crohn-s-disease
#10
Ondrej Fabian, Ondrej Hradsky, Kristyna Potuznikova, Alena Kalfusova, Lenka Krskova, Ludmila Hornofova, Josef Zamecnik, Jiri Bronsky
OBJECTIVES: In pediatric Crohn's disease (PCD), the benefit of microscopy in disease activity assessment and prediction of clinical outcome is, due to the focality and transmurality of the inflammation, disputable. We investigated whether histopathological scoring system predicts complications in pediatric CD and correlates with endoscopical and clinical scores. METHODS: We performed a retrospective study on 63 patients. Endoscopy in the time of diagnosis was evaluated using the Simple Endoscopic Score (SES) and histopathology with the Global Histology Activity Score, both in its original version (GHAS) and its modification (modGHAS)...
January 15, 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/28209416/efficacy-of-an-anal-fistula-plug-for-fistulas-in-ano-in-children
#11
Katsunori Kouchi, Ayao Takenouchi, Aki Matsuoka, Kiyoaki Yabe, Mashahiro Korai, Chikako Nakata
BACKGROUND: In children, perianal abscesses have a good prognosis and often heal with age. However, some perianal abscesses are refractory to treatment and remain as fistulas-in-ano. Treatment with a Surgisis Anal Fistula Plug® has been reported as a new method of treatment for fistulas. In adults, the plug has been reported to cause little pain and have a high cure rate, but there have been no reported cases of its use in children. PURPOSE: This study was designed to analyze the efficacy of the plug for closure of refractory fistulas in children...
February 2, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28194515/genital-and-reproductive-organ-complications-of-crohn-disease-technical-considerations-as-it-relates-to-perianal-disease-imaging-features-and-implications-on-management
#12
REVIEW
Steven Kammann, Christine Menias, Amy Hara, Mariam Moshiri, Cary Siegel, Bashar Safar, Steven Brandes, Akram Shaaban, Kumar Sandrasegaran
OBJECTIVE: A relatively large proportion of patients with Crohn disease (CD) develop complications including abscess formation, stricture, and penetrating disease. A subset of patients will have genital and reproductive organ involvement of CD, resulting in significant morbidity. These special circumstances create unique management challenges that must be tailored to the activity, location, and extent of disease. Familiarity with the epidemiology, pathogenesis, imaging features, and treatment strategies for patients with genital CD can aid imaging diagnoses and guide appropriate patient management...
February 13, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28153572/exploring-endoscopic-therapy-for-the-treatment-of-crohn-s%C3%A2-disease-related-fistula-and-abscess
#13
REVIEW
Bo Shen
Fistula and abscess represent penetrating disease phenotypes of Crohn's disease (CD) and can develop in patients with or without prior history of CD-related surgery. While CD fistula and abscess have been traditionally treated with medical and surgical therapy, the role of endoscopic therapy in this particular phenotype of CD is expanding recently, thanks to advanced endoscopic techniques and a better understanding of pathogenesis and natural history of the disease and principle of treatment. The success of endoscopic treatment for inflammatory bowel disease depends on comprehension and appreciation of principles, then techniques, followed by instrument and device...
January 31, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28127423/comparison-of-trans-anal-endoscopic-operation-and-trans-anal-excision-of-rectal-tumors
#14
Mahdi Hussain Al Bandar, Yoon Dae Han, Syed Asim Razvi, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim
BACKGROUND: Trans-anal endoscopic operation (TEO) has developed to facilitate proper tumor location and ensure excision safely. METHODS: We reviewed 92 patients enrolled in our database between 2006 and 2014 who were diagnosed with early rectal tumors and who underwent conventional trans-anal excision (TAE) or TEO. Clinical data were collected prospectively to compare safety and feasibility between two techniques. RESULTS: Ninety-two patients underwent trans-anal local excision for lower rectal tumors...
February 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28090468/clinical-features-and-extraintestinal-manifestations-of-crohn-disease-in-children
#15
Young Ah Lee, Peter Chun, Eun Ha Hwang, Sang Wook Mun, Yeoun Joo Lee, Jae Hong Park
PURPOSE: The aim of this study was to investigate the clinical features and extraintestinal manifestations (EIMs) of Crohn disease (CD) in Korean pediatric patients. METHODS: The medical records of 73 children diagnosed with CD were retrospectively reviewed. Data regarding baseline demographic and clinical characteristics, including CD phenotype at diagnosis based on the Montreal classification, and clinical features and course of EIMs were investigated. RESULTS: Fifty-two (71...
December 2016: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28087973/granulomas-in-mesenteric-lymph-nodes-in-crohn-s-disease-patients-with-ileocolic-resection-are-areassociated-with-younger-age-and-transmural-inflammation
#16
Xingwen Sun, Lisi Yuan, Yi Li, Bo Shen, Hao Xie, Xiuli Liu
BACKGROUND & AIMS: Mesenteric lymph nodes were usually removed during bowel resection surgery for Crohn's disease (CD). Mesenteric lymph node (MLN) granuloma predicted postoperative disease recurrence in patients with CD after ileocolic resection (ICR). This study was aimed to identify factors associated with MLN granulomas in a cohort of CD patients underwent ICR. METHODS: The study group consisted of 18 patients with CD who underwent the index ICR between 2004 and 2012 and had MLN granulomas...
January 14, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28087156/french-national-consensus-clinical-guidelines-for-the-management-of-crohn-s-disease
#17
Laurent Peyrin-Biroulet, Yoram Bouhnik, Xavier Roblin, Guillaume Bonnaud, Hervé Hagège, Xavier Hébuterne
BACKGROUND: Crohn's disease (CD) is a chronic and disabling condition. There is no curative medical treatment but current treatments provide increasingly sustainable control of the disease and allow patients a better quality of life. There is limited evidence supporting CD management in specific clinical situations, thus precluding an evidence-based approach. AIMS: To help clinicians in making informed treatment decisions, a group of 59 French gastroenterologists with experience in the management of CD met to develop straightforward and practical algorithms based on the European Crohn's and Colitis Organisation (ECCO) recommendations...
April 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28066859/the-long-term-outcome-of-anti-tnf-alpha-therapy-in-perianal-crohn-s-disease
#18
J Rayen, T Currie, R B Gearry, F Frizelle, T Eglinton
BACKGROUND: The aim of the present study was to evaluate the long-term outcomes of anti-tumour necrosis factor alpha therapy in perianal Crohn's disease and identify factors predicting response to treatment. METHODS: Data from hospital clinical records and coding databases were retrospectively reviewed from a tertiary care hospital in Christchurch, New Zealand. The study included 75 adult patients with perianal Crohn's disease commenced on anti-tumour necrosis factor alpha therapy from January 2000 to December 2012...
February 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28000196/-analysis-of-clinical-characteristics-of-perianal-crohn-s-disease-in-a-single-center
#19
Ping Zhu, Yugen Chen, Yunfei Gu, Hongjin Chen, Xiaohai An, Yingrui Cheng, Ying Gao, Bolin Yang
OBJECTIVE: To discuss the clinical features of perianal Crohn disease (PCD). METHODS: Clinical data of 52 PCD patients who were treated at the Department of Colorectal Surgery, Affiliated Hospital of Nanjing University of Chinese Medicine from June 2011 to October 2014 were analyzed retrospectively. Montreal classification, clinical symptoms, the subtype of perianal lesions, history of perianal surgery and medical treatment, disease active indexes, serum inflammation markers and nutritional indexes were included...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27885389/mri-features-of-perianal-fistulas-is-there-a-difference-between-crohn-s-and-non-crohn-s-patients
#20
Irai S Oliveira, Aoife Kilcoyne, Melissa C Price, Mukesh Harisinghani
PURPOSE: Though perianal fistulas are commonly seen in patients with Crohn's disease, they can also be seen in patients without inflammatory bowel disease. The purpose of this study was to evaluate MR imaging differences of perianal fistulas in patients with and without Crohn's disease. METHODS: Our retrospective search from January 2012 to December 2015 of the Radiology database for perianal fistula yielded 207 patients. Only patients with dedicated MR fistula protocol studies were included, whereas patients with previous anal surgery or anastomosis, anorectal tumors, and equivocal findings that could not be definitely assessed as a fistula were excluded...
November 24, 2016: Abdominal Radiology
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