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crohn's abscess

Igors Iesalnieks, Melanie Hoene, Theresa Bittermann, Hans J Schlitt, Christina Hackl
Background: Studies addressing the role of mechanical bowel preparation (MBP) in Crohn's disease (CD) patients are lacking. Methods: Consecutive elective colorectal resections for CD have been included in the present analysis. Exclusion criteria were small bowel resections not including colon, urgent surgeries, surgeries for cancer, and abdominoperineal resections for perianal disease. MBP was performed routinely between 1992 and 2004, omitted between 2005 and 2015, and reintroduced in 2016...
February 24, 2018: Inflammatory Bowel Diseases
Robert P Hirten, Shailja Shah, David B Sachar, Jean-Frederic Colombel
Crohn's disease (CD) leads to the development of complications through progressive uncontrolled inflammation and the transmural involvement of the bowel wall. Most of the available literature on penetrating CD focuses on the perianal phenotype. The management of nonperianal penetrating complications poses its own set of challenges and can result in significant morbidity and an increased risk of mortality. Few controlled trials have been published evaluating this subgroup of patients for clinicians to use for guidance...
March 8, 2018: Inflammatory Bowel Diseases
Peter Bossuyt, Celine Debeuckelaere, Marc Ferrante, Dirk Vanbeckevoort, Thomas Billiet, Albert Wolthuis, Gert van Assche, Andre D'Hoore, Séverine Vermeire
BACKGROUND AND PURPOSE: Crohn's disease (CD) is marked by transmural inflammation of the bowel wall leading to stricturing and/or penetrating complications in the majority of patients. The natural history and operative risk after the diagnosis of an ileal penetrating complication is understudied. The aim was to study the disease course and need for surgery in patients diagnosed with a penetrating ileal CD complication and to assess the risk factors associated with worse postoperative outcome...
February 16, 2018: European Journal of Gastroenterology & Hepatology
Kapil Sahnan, Phil J Tozer, Samuel O Adegbola, Matthew J Lee, Nick Heywood, Angus G K McNair, Daniel Hind, Nuha Yassin, Alan J Lobo, Steven R Brown, Shaji Sebastian, Robin K S Phillips, Phillip F C Lung, Omar D Faiz, Kay Crook, Sue Blackwell, Azmina Verjee, Ailsa L Hart, Nicola S Fearnhead
OBJECTIVE: Lack of standardised outcomes hampers effective analysis and comparison of data when comparing treatments in fistulising perianal Crohn's disease (pCD). Development of a standardised set of outcomes would resolve these issues. This study provides the definitive core outcome set (COS) for fistulising pCD. DESIGN: Candidate outcomes were generated through a systematic review and patient interviews. Consensus was established via a three-round Delphi process using a 9-point Likert scale based on how important they felt it was in determining treatment success culminating in a final consensus meeting...
February 3, 2018: Gut
Stanislaus Argeny, Anton Stift, Michael Bergmann, Martina Mittlböck, Svenja Maschke, Yushan Yang, Praminthra Chitsabesan, Stefan Riss
BACKGROUND: The Neutrophil-to-lymphocyte-ratio has recently gained increased attention as a prognostic marker for malignant disease and short term outcomes. There is little data available in patients with Crohn's disease, thus the present study was conducted to correlate preoperative Neutrophil-to-lymphocyte-ratio values with disease phenotype and postoperative course. METHODS: We comprised 373 patients, who underwent intestinal resection for symptomatic Crohn's disease at an academic tertiary referral centre between 2000 and 2014...
February 12, 2018: Wiener Klinische Wochenschrift
Gisele Aaltonen, Ari Ristimäki, Ilona Keränen, Monika Carpelan-Holmström, Anna Lepistö
OBJECTIVES: Our study assessed whether the presence of histologically inflamed resection margins increased postoperative anastomotic complications in Crohn's disease (CD) patients. We also examined the influence of other risk factors for postoperative complications. MATERIALS AND METHODS: Presence of chronic inflammation and activity of inflammation was scored from the resection margin specimens of 70 patients undergoing surgery due to CD. Anastomotic complications were recorded with a one-month follow-up...
February 12, 2018: Scandinavian Journal of Gastroenterology
Toktam Faghihi, Leila Yavari Tekmehdash, Mania Radfar, Kheirollah Gholami
Objective: Fluoroquinolones are not routinely used as the first-line antimicrobial therapy in pediatrics. The American Academy of Pediatrics (AAP) and the United States Food and Drug Administration (FDA) approved fluoroquinolones on certain indications in children. The aim of this study was to evaluate to what extent and how ciprofloxacin is used on approved indication or as off-label. Besides, dose adequacy and treatment duration were assessed. Methods: In a 10-month observational study, all children receiving systemic ciprofloxacin were assessed...
October 2017: Journal of Research in Pharmacy Practice
P A Reuken, W Kruis, C Maaser, N Teich, J Büning, J C Preiß, R Schmelz, T Bruns, S Fichtner-Feigl, A Stallmach
Background: Intra-abdominal abscesses (IAA) are common life threatening complications in patients with Crohn's disease (CD). In addition to interventional drainage and surgical therapy, empirical antibiotic therapy represents a corner stone of treatment but contemporary data on microbial spectra and antimicrobial resistance are scarce. Methods: We recruited 105 patients with CD and IAA from 9 German centers for a prospective registry in order to characterize the microbiological spectrum, resistance profiles, antibiotic therapy and outcome...
February 5, 2018: Journal of Crohn's & Colitis
Allison Osmond, Dhandapani Ashok, Courtney A Francoeur, Michael Miller, Joanna C Walsh
Focal active colitis (FAC) is a histopathologic finding of uncertain clinical significance in individual patients. In adults, infection accounts for approximately 50%, Crohn's disease (CD) for 0-13%, and 20-30% are idiopathic. One previous study of 29 cases of pediatric FAC showed a 28% rate of CD. This study reviewed a larger cohort of pediatric patients to determine what proportion had IBD, and whether an amount or pattern of inflammation could predict IBD. Sixty eight patients aged ≤18years with FAC were identified and reviewed...
January 20, 2018: Human Pathology
Alexis J Lukach, Melissa I Saul, Laura K Ferris, Jason M Swoger
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder characterized by recurrent nodules, abscesses, and sinus tracts that can be debilitating and significantly impair quality of life. Small studies and case reports have suggested a possible association between HS and inflammatory bowel disease (IBD). AIMS: We performed a case-control study to further characterize IBD patients with HS in terms of smoking status, BMI, sites affected by HS, IBD type and features, and IBD medication history...
January 22, 2018: Digestive Diseases and Sciences
Antony Cougnoux, Miyad Movassaghi, Jaqueline A Picache, James R Iben, Fatemeh Navid, Alexander Salman, Kyle Martin, Nicole Y Farhat, Celine Cluzeau, Wei-Chia Tseng, Kathryn Burkert, Caitlin Sojka, Christopher A Wassif, Niamh X Cawley, Richard Bonnet, Forbes D Porter
BACKGROUND: Niemann-Pick disease, type C (NPC) is a rare lysosomal storage disorder characterized by progressive neurodegeneration, splenomegaly, hepatomegaly, and early death. NPC is caused by mutations in either the NPC1 or NPC2 gene. Impaired NPC function leads to defective intracellular transport of unesterified cholesterol and its accumulation in late endosomes and lysosomes. A high frequency of Crohn disease has been reported in NPC1 patients, suggesting that gastrointestinal tract pathology may become a more prominent clinical issue if effective therapies are developed to slow the neurodegeneration...
January 22, 2018: Digestive Diseases and Sciences
Victoria M Merrick, Kajal Mortier, Linda J Williams, Rafeeq Muhammed, Marcus K H Auth, Mamoun Elawad, John M E Fell, R Mark Beattie, Sabarinathan Loganathan, Franco Torrente, Mary-Anne Morris, Charles Charlton, Nick M Croft, Astor Rodrigues, Mark Furman, Babu Vadamalayan, Huw Jenkins, Veena Zamvar, Sally G Mitton, Sonny Chong, Mike Cosgrove, Anthony Akobeng, David C Wilson, Richard K Russell
OBJECTIVE: The aim of this study was to measure the effectiveness, safety, and use of anti-tumor necrosis Factor (TNF) therapy in pediatric inflammatory bowel disease in the United Kingdom (UK). METHODS: Prospective UK audit of patients newly starting anti-TNF therapy. Disease severity was assessed using Physician Global Assessment +/or the Paediatric Crohn Disease Activity Index. RESULTS: A total of 37 centers participated (23/25 specialist pediatric inflammatory bowel disease sites)...
February 2018: Journal of Pediatric Gastroenterology and Nutrition
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
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
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
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
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
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
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
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
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