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https://www.readbyqxmd.com/read/29300851/magnetic-resonance-imaging-predicts-histopathologic-composition-of-ileal-crohn-s-disease
#1
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/29285682/efficacy-of-autologous-fat-graft-injection-in-the-treatment-of-anovaginal-fistulas
#2
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/29282389/listeria-monocytogenes-brain-abscess-in-crohn-s-disease-treated-with-adalimumab
#3
Amporn Atsawarungruangkit, Fernando Dominguez, Gustavo Borda, Nikolaos Mavrogiorgos
Listeria monocytogenes is a gram-positive bacterium that causes listeriosis. Brain abscess is a very uncommon manifestation of listeriosis and has not been reported to be associated with adalimumab (humira), one of the approved medications for treating Crohn's disease. A 45-year-old female with Crohn's disease presented with sudden onset of fever, headache, nausea, vomiting, and altered mental status for 1 day. She was on prednisone and 6-mercaptopurine. She had started taking adalimumab 17 days prior to admission...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29275447/old-and-new-lymphocyte-players-in-inflammatory-bowel-disease
#4
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/29247068/randomised-trial-and-open-label-extension-study-of-an-anti-interleukin-6-antibody-in-crohn-s-disease-andante-i-and-ii
#5
Silvio Danese, Séverine Vermeire, Paul Hellstern, Remo Panaccione, Gerhard Rogler, Gerald Fraser, Anna Kohn, Pierre Desreumaux, Rupert W Leong, Gail M Comer, Fabio Cataldi, Anindita Banerjee, Mary K Maguire, Cheryl Li, Natalie Rath, Jean Beebe, Stefan Schreiber
OBJECTIVE: Neutralising pro-inflammatory interleukin-6 (IL-6) may effectively treat Crohn's disease (CD). Effects of PF-04236921, an anti-IL-6 antibody, in adults with CD are reported. DESIGN: Parallel-group, dose-ranging, double-blind trial with 4-week screening and 12-week treatment periods. After induction, patients entered 28-week follow-up or 48-week open-label extension (OLE) with 28-week follow-up. Adults with confirmed CD and inadequate response to anti-tumour necrosis factor (TNF) therapy were included...
December 15, 2017: Gut
https://www.readbyqxmd.com/read/29220430/postoperative-outcomes-in-ustekinumab-treated-patients-undergoing-abdominal-operations-for-crohn-s-disease
#6
Amy L Lightner, Nicholas P McKenna, Chung Sang Tse, Neil Hyman, Radhika Smith, Gayane Ovsepyan, Phillip Fleshner, Kristen Crowell, Walter Koltun, Marc Ferrante, Andre D'Hoore, Nathalie Lauwers, Bram Verstockt, Antonino Spinelli, Francesca DiCandido, Laura E Raffals, Kellie L Mathis, Edward V Loftus
Introduction: Ustekinumab, a monoclonal antibody targeting interleukins-12 and -23 is used to treat adults with Crohn's disease (CD). We determined the 30-day postoperative infectious complication rate among CD patients who received ustekinumab within 12 weeks prior to an abdominal operation as compared to patients who received anti-tumor necrosis factor (TNF) agents. Methods: A retrospective chart review of adults with CD who underwent an abdominal operation between 1/1/2015 and 5/1/2017 was performed across six sites...
December 6, 2017: Journal of Crohn's & Colitis
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
#7
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/29212476/the-role-of-endoscopic-ultrasound-in-children-with-pancreatobiliary-and-gastrointestinal-disorders-a-single-center-series-and-review-of-the-literature
#8
Alessandro Fugazza, Barbara Bizzarri, Federica Gaiani, Marco Manfredi, Alessia Ghiselli, Pellegrino Crafa, Maria Clotilde Carra, Nicola de'Angelis, Gian Luigi de'Angelis
BACKGROUND: The role of endoscopic ultrasound (EUS) in the management of pancreatobiliary and digestive diseases is well established in adults, but it remains limited in children. The aim of this study was to evaluate the feasibility, safety, and clinical impact of EUS use in children. METHODS: This is a retrospective analysis of a prospectively acquired database of consecutive pediatric (< 18 years) patients presenting an indication for EUS for pancreatobiliary and gastrointestinal disorders...
December 6, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/29212102/-conservative-treatment-of-an-aseptic-abscess-syndrome-with-splenic-abscesses-in-crohn-s-disease
#9
Thomas Göbel, Jutta Rauen-Vossloh, Hubert Georg Hotz, Andree Boldt, Andreas Erhardt
A 24-year old woman with a history of Crohn's disease developed bloody diarrhea and multiple abdominal abscesses, daily fever, leukocytosis, and elevated CRP several months after her immunosuppressive therapy with azathioprine was stopped. Recurrent abscess punctures did not detect any pathogenic germs and neither clinical nor serological response was achieved by administration of different antimicrobial therapies. Additionally, new splenic abscesses arose despite ongoing therapy. Under the suspicion of the rare aseptic abscess syndrome, representing an auto-inflammatory, extra-intestinal manifestation of Crohn's disease, the antimicrobial therapy was stopped and an intravenous therapy with prednisolone was initiated...
December 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29169000/hidradenitis-suppurativa-and-crohn-s-disease-a-case-series
#10
S Kirthi, R Hellen, R O'Connor, M Connolly, A M Tobin, D McNamara
Hidradenitis Suppurativa (HS) is characterized by chronic recurrent abscesses, nodules and draining sinus tracts with scar formation. Cutaneous Crohn's Disease (CD) may also present similarly. We wished to identify and describe an Irish cohort with combined HS and CD, with a view to a better recognition of clinical manifestations and understanding of the pathophysiology underlying these two overlapping conditions. Cases were identified using the HIPE Code at Tallaght Hospital from 1990-2014 and retrospective review was performed...
August 12, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/29135086/can-mr-enterography-screen-for-perianal-disease-in-pediatric-inflammatory-bowel-disease
#11
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/29028958/development-of-clinical-prediction-models-for-surgery-and-complications-in-crohn-s-disease
#12
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/28980821/enteral-nutrition-is-associated-with-a-decreased-risk-of-surgical-intervention-in-crohn-s-disease-patients-with-spontaneous-intra-abdominal-abscess
#13
Xiao-Bin Zheng, Xiang Peng, Xiao-Yu Xie, Lei Lian, Xian-Rui Wu, Jian-Cong Hu, Xiao-Wen He, Jia Ke, Yu-Feng Chen, Min Zhi, Xiao-Jian Wu, Xiao-Sheng He, Ping Lan
BACKGROUND: The impact of enteral nutrition (EN) on surgical risk in Crohn's disease (CD) patients suffering from spontaneous intra-abdominal abscess (IAA) was evaluated. METHODS: CD patients diagnosed with spontaneous IAA from 2008 to 2015 were included in the study. The impact of EN on surgical risk was evaluated using both univariate and multivariate analyses. RESULTS: A total of 87 patients were enrolled, 66 (75.9%) were male. The mean age at the development of an abscess was 30...
October 5, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28979892/the-adjunctive-role-of-nutritional-therapy-in-the-management-of-phlegmon-in-two-children-with-crohn-s-disease
#14
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/28953535/comparison-of-transperianal-ultrasound-with-colonoscopy-and-magnetic-resonance-imaging-in-perianal-crohn-s-disease
#15
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/28947899/safety-and-efficacy-of-exclusive-enteral-nutrition-for-percutaneously-undrainable-abdominal-abscesses-in-crohn-s-disease
#16
Yibin Zhu, Liang Xu, Wei Liu, Weilin Qi, Qian Cao, Wei Zhou
BACKGROUND: The percutaneously undrainable abdominal abscesses in Crohn's disease (CD) are not uncommon. The treatment protocol is still under debate. This study was conducted to assess the safety and efficacy of exclusive enteral nutrition (EEN) for percutaneously undrainable abscesses in CD. METHODS: A consecutive cohort of 83 CD patients with percutaneously undrainable abdominal abscesses between January 2011 and June 2015 was retrospectively analyzed. They were divided into the EEN group and the non-EEN group...
2017: Gastroenterology Research and Practice
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
#17
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
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
#18
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/28885229/impact-of-diagnostic-delay-and-associated-factors-on-clinical-outcomes-in-a-u-s-inflammatory-bowel-disease-cohort
#19
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...
October 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28857130/natural-history-of-anorectal-sepsis
#20
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...
December 2017: British Journal of Surgery
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