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https://www.readbyqxmd.com/read/28427855/outcome-of-medical-management-of-intraabdominal-abscesses-in-children-with-crohn-s-disease
#1
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
#2
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
#3
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
#4
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/28361220/disease-severity-and-treatment-requirements-in-familial-inflammatory-bowel-disease
#5
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
https://www.readbyqxmd.com/read/28344795/validation-of-a-tool-predicting-important-findings-on-computed-tomography-among-crohn-s-disease-patients
#6
REVIEW
Shail M Govani, Akbar K Waljee, Keith E Kocher, Jason M Swoger, Melissa Saul, Peter Dr Higgins
BACKGROUND: Patients with Crohn's disease (CD) are frequently subjected to computed tomography (CT) in the emergency department (ED). This young population is at higher risk of malignancy from radiation exposure. OBJECTIVES: We aimed to validate a decision tool predicting complications (perforation, abscess or other serious finding) on imaging at two sites. METHODS: We conducted a retrospective review of CT outcomes among patients with CD with ED visits at two tertiary care centers...
March 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28319427/new-horizons-in-the-imaging-of-perianal-crohn-s-disease-transperineal-ultrasonography
#7
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/28286192/endoscopic-and-histologic-healing-in-children-with-inflammatory-bowel-diseases-treated-with-thalidomide
#8
Marzia Lazzerini, Vincenzo Villanacci, Maria Chiara Pellegrin, Stefano Martelossi, Giuseppe Magazzù, Salvatore Pellegrino, Maria Cristina Lucanto, Arrigo Barabino, Angela Calvi, Serena Arrigo, Paolo Lionetti, Massimo Fontana, Giovanna Zuin, Giuseppe Maggiore, Matteo Bramuzzo, Massimo Maschio, Marianna Salemme, Stefania Manenti, Lorenzi Luisa, Giuliana Decorti, Marcella Montico, Alessandro Ventura
BACKGROUND & AIMS: Mucosal healing, determined by endoscopic evaluation, is one of the most important prognostic markers for patients with inflammatory bowel diseases. Findings from histologic evaluation, however, could complement findings from endoscopy in assessing mucosal responses to treatment. We analyzed long term results of children treated with thalidomide to determine the association between clinical response and histology and endoscopy findings. METHODS: We collected data from 2 multi-center trials of 70 children with refractory Crohn's disease (CD) or ulcerative colitis (UC) (2-18 years old; ileo-colonic or colonic disease) given thalidomide or placebo (NCT00720538)...
March 7, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28271435/adalimumab-therapy-in-a-patient-with-crohn-s-disease-with-a-giant-pelvic-paraganglioma-after-chemotherapy
#9
Tsutomu Mizoshita, Masashi Ando, Hiroyuki Sagawa, Yoshinori Mori, Takahito Katano, Keiji Ozeki, Satoshi Tanida, Yasuyuki Okamoto, Takaya Shimura, Eiji Kubota, Hiromi Kataoka, Takeshi Kamiya, Takashi Joh
A 23-year-old man was diagnosed with a giant pelvic paraganglioma in September 2013, and a 6-month chemotherapy course was performed. The chemotherapy resulted in stable disease of the tumor for about 1 year. However, in April 2015, the patient complained of fever and diarrhea of more than ten times a day. Endoscopy showed serpiginous (snake-like) ulcers in the cecum, ascending, descending, and sigmoid colons, with granulomas without caseation histologically. The patient was diagnosed with the active stage of Crohn's disease (CD) in June 2015...
March 7, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28271331/five-years-of-experience-with-the-filac%C3%A2-laser-for-fistula-in-ano-management-long-term-follow-up-from-a-single-institution
#10
A Wilhelm, A Fiebig, M Krawczak
BACKGROUND: There are limited data available concerning endofistular therapies for fistula-in-ano, with our group reporting the first preliminary outcomes of the use of the radial fibre Fistula laser Closing (FiLaC ™) device. METHODS: The aim of this study was to assess a cohort of anal fistulae managed with laser ablation plus definitive flap closure of the internal fistula opening over a long-term follow-up. Factors governing primary healing success and secondary healing success (i...
March 7, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28267043/a-fixed-stricture-on-routine-cross-sectional-imaging-predicts-disease-related-complications-and-adverse-outcomes-in-patients-with-crohn-s-disease
#11
Naueen A Chaudhry, Michael Riverso, Joseph R Grajo, Patricia P Moser, Fei Zou, Maher Homsi, Darashana R Punglia, Ellen M Zimmermann
BACKGROUND: Patients with Crohn's disease (CD) typically undergo multiple cross-sectional imaging exams including computed tomography and magnetic resonance enterography during the course of their disease. The aim was to identify imaging findings that predict future disease-related poor outcomes. METHODS: This was a retrospective, case control study at a single tertiary center. Cases were CD patients diagnosed with complications (bowel obstruction, perforation, internal fistula, or abscess); controls were CD patients without complications...
April 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28255489/newly-diagnosed-colonic-adenocarcinoma-the-presenting-sign-in-a-young-woman-with-undiagnosed-crohn-s-disease-in-the-absence-of-primary-sclerosing-cholangitis-and-a-normal-microsatellite-instability-profile
#12
Brett Matthew Lowenthal, Ann M Ponsford Tipps
Ulcerative colitis has long been linked with an increased risk for colonic adenocarcinoma, whereas Crohn's disease (CD) has recently been reported to pose a similar increased risk. We report a 33-year-old healthy female with no family history who presented with abdominal pain and a colon mass. Histopathology revealed a moderately differentiated adenocarcinoma extending through the muscularis propria with metastatic lymph nodes and intact mismatch repair proteins by immunohistochemical expression and gene sequencing...
2017: Case Reports in Pathology
https://www.readbyqxmd.com/read/28251812/risk-factors-and-clinical-outcome-of-clostridium-difficile-infection-in-patients-with-ibd-a-chinese-single-center-retrospective-study-of-260-cases
#13
YuBei Gu, Mao Chen Zhang, Jing Sun, KeZhi Lv, Jie Zhong
AIM: Clostridium difficile infection(CDI) may lead to poor outcome in inflammatory bowel disease(IBD) patients. This study was designed to investigate the cumulative incidence, risk factors, and outcome of CDI in patients with IBD in one Chinese single center. METHODS: Clinical features and endoscopic profiles of consecutive IBD patients from RuiJin Hospital between January 2013 and December 2015 were analyzed retrospectively. CDI was diagnosed based on the positive polymerase chain reaction (PCR)-based stool test...
March 2, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28216137/low-predictive-value-of-histopathological-scoring-system-for-complications-development-in-children-with-crohn-s-disease
#14
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/28203422/colobronchial-fistula-the-pathogenesis-clinical-presentations-diagnosis-and-treatment
#15
Jinbo Zhao, Nan Ma, Zhengwei Zhao, Jie Lei, Qiang Lu, Feng Tian, Yongan Zhou, Yong Han, Xiaofei Li
BACKGROUND: Colobronchial fistula (CBF) is rare and easy to be delayed in clinic. There is no systemic study about this disease. The pathogenesis, clinical presentations, diagnosis and treatment of CBF were analyzed in this study. METHODS: The clinical data from 37 cases of CBF, which included one case in our institute and the other 36 cases in literature from January 1960 to August 2016, were reviewed and analyzed. The etiology, clinical presentations, diagnostic and therapeutic methods, and outcomes were summarized...
January 2017: Journal of Thoracic Disease
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
#16
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
#17
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/28116809/accuracy-of-magnetic-resonance-enterography-in-the-preoperative-assessment-of-patients-with-small-bowel-crohn-s-disease
#18
Salvador Pous-Serrano, Matteo Frasson, Rosana Palasí Giménez, Gonzalo Sanchez-Jordá, Jose Pamies-Guilabert, Margarita Llavador Ros, Pilar Nos Mateu, Eduardo Garcia-Granero
AIM: to assess the accuracy of magnetic resonance-enterography in predicting the extension, location and characteristics of the small bowel segments affected by Crohn's disease. METHOD: This is a prospective study including a consecutive series of 38 patients with small bowel Crohn's disease who underwent surgery at a specialized colorectal unit of a tertiary hospital. Preoperative magnetic resonance enterography was performed in all patients, following a homogeneous protocol, within the three months prior to surgery...
January 24, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28105752/exclusive-enteral-nutrition-provides-an-effective-bridge-to-safer-interval-elective-surgery-for-adults-with-crohn-s-disease
#19
N Heerasing, B Thompson, P Hendy, G A Heap, G Walker, R Bethune, S Mansfield, C Calvert, N A Kennedy, T Ahmad, J R Goodhand
BACKGROUND: Few studies have reported the systematic use of exclusive enteral nutrition in the perioperative setting. AIM: To test the hypothesis that exclusive enteral nutrition provides a safe and effective bridge to surgery and reduces post-operative complications, in adult patients with Crohn's disease requiring urgent surgery for stricturing or penetrating complications. METHODS: Patients treated with exclusive enteral nutrition prior to surgery were each matched with two control patients for disease behaviour, type of surgery, age at diagnosis and disease duration...
March 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28091846/risk-factors-of-surgical-site-infections-in-patients-with-crohn-s-disease-complicated-with-gastrointestinal-fistula
#20
Kun Guo, Jianan Ren, Guanwei Li, Qiongyuan Hu, Xiuwen Wu, Zhiwei Wang, Gefei Wang, Guosheng Gu, Huajian Ren, Zhiwu Hong, Jieshou Li
PURPOSE: Surgical site infection (SSI) is the most common complication following surgical procedures. This study aimed to determine risk factors associated with SSI in patients with Crohn's disease (CD) complicated with gastrointestinal fistula. METHODS: This was a retrospective review of patients who underwent surgical resection in gastrointestinal fistula patients with CD between January 2013 and January 2015, identified from a prospectively maintained gastrointestinal fistula database...
May 2017: International Journal of Colorectal Disease
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