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https://www.readbyqxmd.com/read/28633544/medical-versus-surgical-management-of-penetrating-crohn-s-disease-the-current-situation-and-future-perspectives
#1
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
#2
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 15, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28609262/image-diagnosis-iliopsoas-abscess-from-crohn-disease
#3
Ashley S Abraham, Michelle Y Liu, David R Vinson
No abstract text is available yet for this article.
2017: Permanente Journal
https://www.readbyqxmd.com/read/28604511/incidence-and-risk-factors-for-perianal-disease-in-pediatric-crohn-s-disease-patients-followed-in-cedata-gpge-registry
#4
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
#5
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...
June 9, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28573532/-surgical-strategy-to-save-ileoanal-pouch-reconstruction
#6
REVIEW
A J Kroesen
Restorative proctocolectomy under formation of an ileoanal/ileorectal J‑pouch has become the procedure of choice in the therapy of ulcerative colitis. Although patients experience a dramatic improvement of their quality of life, surgery is not successful in about 5-10% of all treated patients. The reasons for failure are chronic pouchitis, incontinence, delayed diagnosis of Crohn's disease, fistula, surgical complications, too long remnant rectal stump, chronic abscess, and surgical technical errors. Some of the reasons do not always prevent the loss of a well-functioning ileoanal pouch...
June 1, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28559086/laparoscopic-intervention-in-acute-crohn-s-disease-involving-an-ovary
#7
Iwona Gawron, Lukasz Chmura, Dariusz Adamek, Krzysztof Skotniczny, Kazimierz Pityński, Artur Ludwin
Crohn's disease (CD) is a chronic inflammatory disorder that may involve any part of the gastrointestinal tract. Acute manifestations in female internal reproductive organs are rare and have been described in only a few cases. A 27-year-old nulligravida diagnosed with CD presented with pelvic pain, fever, and a palpable mass (confirmed by ultrasound) in the right lower quadrant of the abdomen. She underwent diagnostic laparoscopy because of worsening symptoms suggestive of a tubo-ovarian abscess. The right adnexa were excised after adhesiolysis...
May 27, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28534335/-consistency-analysis-between-preoperative-ct-enterography-and-intraoperative-findings-in-patients-undergoing-surgery-for-crohn-s-disease
#8
Jianbo Yang, Jianfeng Gong, Yi Li, Lili Gu, Weiming Zhu, Jieshou Li
OBJECTIVE: To evaluate the diagnostic value of preoperative CT enterography (CTE) on obstruction, fistula and abscess formation compared to intraoperative findings in patients undergoing surgery for Crohn's disease(CD), aiming to provide reference to clinical practice. METHODS: Preoperative CTE data of 176 CD patients confirmed by clinic, endoscopy, imaging, operation and pathology at the Department of General Surgery in Nanjing Jinling Hospital from January 2013 to December 2015 were enrolled in retrospective cohort study...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28527172/metastatic-crohn-s-disease
#9
Deepak N Amarapurkar, Amey Sonavane, Anjali D Amarapurkar
Metastatic cutaneous involvement is a rare extraintestinal manifestation of Crohn's disease. Presence of cutaneous noncaseating granulomas that are anatomically noncontiguous in location with a fistula or the gastrointestinal tract is a diagnostic hallmark. We present a case of inflammatory bowel disease initially diagnosed as ulcerative colitis, but later manifesting as intra-abdominal abscesses and ulcerated cutaneous lesions that on biopsy proved to be metastatic Crohn's disease. The patient promptly responded to corticosteroid therapy...
April 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28509817/modified-delphi-process-for-the-development-of-choosing-wisely-for-inflammatory-bowel-disease
#10
Geoffrey C Nguyen, Karen Boland, Waqqas Afif, Brian Bressler, Jennifer L Jones, Adam V Weizman, Sharyle Fowler, Smita Halder, Vivian W Huang, Gilaad G Kaplan, Reena Khanna, Sanjay K Murthy, Joannie Ruel, Cynthia H Seow, Laura E Targownik, Tanya Chawla, Luis Guimaraes, Aida Fernandes, Sherif Saleh, Gil Y Melmed
BACKGROUND AND AIMS: The prevalence and incidence of inflammatory bowel disease (IBD) in North America is among the highest in the world and imparts substantial direct and indirect medical costs. The Choosing Wisely Campaign was launched in wide variety of medical specialties and disciplines to reduce unnecessary or harmful tests or treatment interventions. METHODS: The Choosing Wisely list for IBD was developed by the Canadian IBD Network for Research and Growth in Quality Improvement (CINERGI) in collaboration with Crohn's and Colitis Canada (CCC) and the Canadian Association of Gastroenterology (CAG)...
June 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28509768/modified-delphi-process-for-the-development-of-choosing-wisely-for-inflammatory-bowel-disease
#11
Geoffrey C Nguyen, Karen Boland, Waqqas Afif, Brian Bressler, Jennifer L Jones, Adam V Weizman, Sharyle Fowler, Smita Halder, Vivian W Huang, Gilaad G Kaplan, Reena Khanna, Sanjay K Murthy, Joannie Ruel, Cynthia H Seow, Laura E Targownik, Tanya Chawla, Luis Guimaraes, Aida Fernandes, Sherif Saleh, Gil Y Melmed
BACKGROUND AND AIMS: The prevalence and incidence of inflammatory bowel disease (IBD) in North America is among the highest in the world and imparts substantial direct and indirect medical costs. The Choosing Wisely Campaign was launched in wide variety of medical specialties and disciplines to reduce unnecessary or harmful tests or treatment interventions. METHODS: The Choosing Wisely list for IBD was developed by the Canadian IBD Network for Research and Growth in Quality Improvement (CINERGI) in collaboration with Crohn's and Colitis Canada (CCC) and the Canadian Association of Gastroenterology (CAG)...
May 15, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28486175/ileocaecal-and-transverse-colonic-tuberculosis-mimicking-colonic-malignancy-a-case-report
#12
Prashant Lakhe, Asma Khalife, Jayashri Pandya
INTRODUCTION: Gastrointestinal tuberculosis is common in the developing world especially in the lower socioeconomic groups. In elderly, it may mimic malignancy. CASE PRESENTATION: A 46-year-old female presented with a 6 month history of diffuse pain in abdomen with low grade fever and loss of weight and appetite. Clinically, differential of malignancy of the large bowel was considered. The computerized tomography(CT) scan of the abdomen revealed a diffuse concentric long segmental thickening of terminal ileum, ileo ceacal junction, ascending colon and narrowing of the transverse colonic end of the splenic flexure suggesting an infective etiology...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28469460/medical-versus-interventional-treatment-of-intra-abdominal-abscess-in-patients-with-crohn-disease
#13
Emily Graham, Krishna Rao, Sandro Cinti
BACKGROUND: Few studies exist to guide the treatment approach to intra-abdominal abscesses in Crohn disease, which can include antimicrobials alone or in conjunction with percutaneous drainage or surgery. The primary aim of this study is to review outcomes from different treatment approaches to intra-abdominal abscess in Crohn disease. METHODS: Medical records were reviewed for patients admitted to the University of Michigan health care system with Crohn disease and intra-abdominal abscess over a 4-year period...
2017: Infectious Diseases
https://www.readbyqxmd.com/read/28465780/laparoscopic-surgery-for-complex-and-recurrent-crohn-s-disease
#14
EDITORIAL
Yusuf Sevim, Cihangir Akyol, Erman Aytac, Bilgi Baca, Orhan Bulut, Feza H Remzi
Crohn's disease (CD) is a chronic inflammatory disease of digestive tract. Approximately 70% of patients with CD require surgical intervention within 10 years of their initial diagnosis, despite advanced medical treatment alternatives including biologics, immune suppressive drugs and steroids. Refractory to medical treatment in CD patients is the common indication for surgery. Unfortunately, surgery cannot cure the disease. Minimally invasive treatment modalities can be suitable for CD patients due to the benign nature of the disease especially at the time of index surgery...
April 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28458507/endoscopy-and-cross-sectional-imaging-for-assessing-crohn-s-disease-activity
#15
Ryan W Stidham, Raymond K Cross
Crohn's disease (CD) is principally characterized by chronic and recurrent inflammation of the gastrointestinal tract, most commonly found in the ileo-colonic region. The chronicity and severity of intestinal inflammation together contribute to progressive, cumulative, deep, transmural intestinal damage, including stricturing, obstruction, abscesses, and fistulae. Both intestinal inflammation and its chronic complications result in a range of symptoms subsequently leading to patient presentations with diarrhea, abdominal pain, and anemia related to intestinal blood loss...
July 2016: Techniques in Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28427855/outcome-of-medical-management-of-intraabdominal-abscesses-in-children-with-crohn-s-disease
#16
Razan H Alkhouri, Gracielle Bahia, Ashley C Smith, Richard Thomas, Christine Finck, Wael Sayej
INTRODUCTION: Crohn's disease (CD) is a chronic inflammatory condition of the gastrointestinal tract that is complicated by fistulas, strictures, and intraabdominal abscesses (IAA) in 10%-30% of patients. To avoid surgical resection of the bowel, medical therapy with antibiotics (Ab) with or without percutaneous drainage (PD) is first undertaken. Our objectives are to examine the outcome of IAA in CD patients treated with antibiotics alone vs antibiotics and PD, and to identify risk factors for medical therapy failure...
March 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28401425/medical-therapies-for-stricturing-crohn-s-disease-efficacy-and-cross-sectional-imaging-predictors-of-therapeutic-failure
#17
Cécile Campos, Antoine Perrey, Céline Lambert, Bruno Pereira, Marion Goutte, Anne Dubois, Felix Goutorbe, Michel Dapoigny, Gilles Bommelaer, Constance Hordonneau, Anthony Buisson
BACKGROUND: Medical therapy efficacy remains controversial in stricturing Crohn's disease. Cross-sectional imaging, especially magnetic resonance imaging, has been suggested as very helpful to guide therapeutic decision making. AIM: To assess efficacy and predictors of therapeutic failure in patients receiving medical treatments for stricturing Crohn's disease. METHODS: In this retrospective study, therapeutic failure was defined as symptomatic stricture leading to surgical or endoscopic therapeutics, hospitalization, treatment discontinuation or additional therapy and short-term clinical response as clinical improvement assessed by two physicians...
April 11, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28401051/surgery-in-pediatric-crohn-s-disease-indications-timing-and-post-operative-management
#18
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
#19
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...
June 2017: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/28361220/disease-severity-and-treatment-requirements-in-familial-inflammatory-bowel-disease
#20
María Pilar Ballester, David Martí, Joan Tosca, Marta Maia Bosca-Watts, Ana Sanahuja, Pablo Navarro, Isabel Pascual, Rosario Antón, Francisco Mora, Miguel Mínguez
PURPOSE: Several studies demonstrate an increased prevalence and concordance of inflammatory bowel disease among the relatives of patients. Other studies suggest that genetic influence is over-estimated. The aims of this study are to evaluate the phenotypic expression and the treatment requirements in familial inflammatory bowel disease, to study the relationship between number of relatives and degree of kinship with disease severity and to quantify the impact of family aggregation compared to other environmental factors...
March 31, 2017: International Journal of Colorectal Disease
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