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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
#1
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
#2
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...
September 6, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28857130/natural-history-of-anorectal-sepsis
#3
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...
August 31, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28851611/the-efficacy-of-infliximab-combined-with-surgical-treatment-of-fistulizing-perianal-crohn-s-disease-comparative-analysis-according-to-fistula-subtypes
#4
Eun Jung Park, Ki-Hwan Song, Seung Hyuk Baik, Jae Jun Park, Jeonghyun Kang, Kang Young Lee, Ja Il Goo, Nam Kyu Kim
BACKGROUND/OBJECTIVE: Infliximab is regarded as an effective therapeutic to treat Crohn's disease. This study aimed to assess the efficacy of infliximab combined with surgery and to analyze clinical manifestations according to fistula subtypes in patients with fistulizing perianal Crohn's disease. METHODS: From April 2013 to December 2015, 47 patients with perianal Crohn's disease in two hospitals of South Korea (Goo Hospital, Gangnam Severance Hospital) were evaluated retrospectively...
August 26, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28839437/elaboration-and-validation-of-crohn-s-disease-anoperineal-lesions-consensual-definitions
#5
Clémence Horaist, Vincent de Parades, Laurent Abramowitz, Paul Benfredj, Guillaume Bonnaud, Dominique Bouchard, Nadia Fathallah, Agnès Sénéjoux, Laurent Siproudhis, Ghislain Staumont, Manuelle Viguier, Philippe Marteau
AIM: To establish consensual definitions of anoperineal lesions of Crohn's (APLOC) disease and assess interobserver agreement on their diagnosis between experts. METHODS: A database of digitally recorded pictures of APLOC was examined by a coordinating group who selected two series of 20 pictures illustrating the various aspects of APLOC. A reading group comprised: eight experts from the Société Nationale Française de Colo Proctologie group of study and research in proctology and one academic dermatologist...
August 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28838644/laparoscopic-ileocaecal-resection-versus-infliximab-for-terminal-ileitis-in-crohn-s-disease-a-randomised-controlled-open-label-multicentre-trial
#6
Cyriel Y Ponsioen, E Joline de Groof, Emma J Eshuis, Tjibbe J Gardenbroek, Patrick M M Bossuyt, Ailsa Hart, Janindra Warusavitarne, Christianne J Buskens, Ad A van Bodegraven, Menno A Brink, Esther C J Consten, Bart A van Wagensveld, Marno C M Rijk, Rogier M P H Crolla, Casper G Noomen, Alexander P J Houdijk, Rosalie C Mallant, Maarten Boom, Willem A Marsman, Hein B Stockmann, Bregje Mol, A Jeroen de Groof, Pieter C Stokkers, Geert R D'Haens, Willem A Bemelman
BACKGROUND: Treatment of patients with ileocaecal Crohn's disease who have not responded to conventional therapy is commonly scaled up to biological agents, but surgery can also offer excellent short-term and long-term results. We compared laparoscopic ileocaecal resection with infliximab to assess how they affect health-related quality of life. METHODS: In this randomised controlled, open-label trial, in 29 teaching hospitals and tertiary care centres in the Netherlands and the UK, adults with non-stricturing, ileocaecal Crohn's disease, in whom conventional therapy has failed were randomly allocated (1:1) by an internet randomisation module with biased-coin minimisation for participating centres and perianal fistula to receive laparoscopic ileocaecal resection or infliximab...
August 21, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28826742/a-comprehensive-review-and-update-on-crohn-s-disease
#7
Mahesh Gajendran, Priyadarshini Loganathan, Anthony P Catinella, Jana G Hashash
The term inflammatory bowel disease (IBD) refers principally to two major categories of chronic relapsing inflammatory intestinal disorders: Crohn's disease (CD) and ulcerative colitis (UC). In the United States, it is currently estimated that about 1.5 million people suffer from IBD, causing considerable suffering, mortality and economic loss every year. Yet the cause of IBD is unknown, and until we understand more, prevention or cure will not be possible. There is a lot of variation in the incidence and prevalence of CD based on geographic region, environment, immigrant population, and ethnic groups...
August 18, 2017: Disease-a-month: DM
https://www.readbyqxmd.com/read/28790453/perianal-fistulizing-crohn-s-disease-pathogenesis-diagnosis-and-therapy
#8
REVIEW
Julián Panés, Jordi Rimola
Perianal fistulizing Crohn's disease has a major negative effect on patient quality of life and is a predictor of poor long-term outcomes. Factors involved in the pathogenesis of perianal fistulizing Crohn's disease include an increased production of transforming growth factor β, TNF and IL-13 in the inflammatory infiltrate that induce epithelial-to-mesenchymal transition and upregulation of matrix metalloproteinases, leading to tissue remodelling and fistula formation. Care of patients with perianal Crohn's disease requires a multidisciplinary approach...
August 9, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28753181/real-life-anti-tumour-necrosis-factor-experience-in-500-paediatric-united-kingdom-inflammatory-bowel-disease-patients
#9
Victoria M Merrick, Kajal Mortier, Linda J Williams, Rafeeq Muhammed, Marcus Kh Auth, Mamoun Elawad, John Me 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
OBJECTIVES: To measure the effectiveness, safety and use of anti-Tumour necrosis Factor (TNF) therapy in paediatric inflammatory bowel disease (PIBD) in the United Kingdom (UK). METHODS: Prospective UK audit of patients newly starting anti-TNF therapy. Disease severity was assessed using Physician Global Assessment (PGA) +/or the Paediatric Crohn's Disease Activity Index (PCDAI). RESULTS: 37 centres participated (23 of 25 specialist PIBD sites)...
July 27, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28738237/a-case-report-of-unexpected-pathology-within-an-incarcerated-ventral-hernia
#10
Erica D Kane, Katharine R Bittner, Michelle Bennett, John R Romanelli, Neal E Seymour, Jacqueline J Wu
INTRODUCTION: Incidence of hernial appendicitis is 0.008%, most frequently within inguinal and femoral hernias. Up to 2.5% of appendectomy patients are found to have Crohn's disease. Elucidating the etiology of inflammation is essential for directing management. PRESENTATION OF CASE: A 51-year-old female with achondroplastic dwarfism, multiple cesarean sections, and subsequent massive incisional hernia, presented with ruptured appendicitis within her incarcerated hernia...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28690491/a-complicated-thread-abdominal-actinomycosis-in-a-young-woman-with-crohn-disease
#11
Ari Nahum, Gregory Filice, Ashish Malhotra
Crohn disease is a chronic inflammatory condition that primarily affects the gastrointestinal tract. Typical manifestations include fever, weight loss, fatigue, and abdominal pain, and abdominal abscesses and fistulae are frequent complications. Abdominal actinomycosis is a subacute or indolent disease associated with Actinomyces spp. Symptoms can be very similar to those of Crohn disease, and fistulae are also common. Since ulcerations in the intestinal tract are thought to be caused by Actinomyces escaping from the gut lumen and establishing intra-abdominal infection, it seems likely that abdominal actinomycosis may occur in patients with inflammatory bowel disease...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28684845/multiple-fresh-fecal-microbiota-transplants-induces-and-maintains-clinical-remission-in-crohn-s-disease-complicated-with-inflammatory-mass
#12
Zhi He, Pan Li, Jianguo Zhu, Bota Cui, Lijuan Xu, Jie Xiang, Ting Zhang, Chuyan Long, Guangming Huang, Guozhong Ji, Yongzhan Nie, Kaichun Wu, Daiming Fan, Faming Zhang
The ancient Chinese medical literature, as well as our prior clinical experience, suggests that fecal microbiota transplantation (FMT) could treat the inflammatory mass. We aimed to evaluate the efficacy and safety of multiple fresh FMTs for Crohn's disease (CD) complicated with intraabdominal inflammatory mass. The "one-hour FMT protocol" was followed in all patients. Twenty-five patients were diagnosed with CD and related inflammatory mass by CT or MRI. All patients received the initial FMT followed by repeated FMTs every 3 months...
July 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28647459/treatment-of-aseptic-liver-abscess-due-to-crohn-s-disease-using-infliximab
#13
Yang Yang, Dongfeng Chen
No abstract text is available yet for this article.
June 21, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28644565/long-term-risk-of-infection-in-patients-with-crohn-s-disease-on-anti-tnf-treatment-a-prospective-single-center-cohort-study-in-china
#14
Yue Li, Hui Jun Shu, Hong Lu, Hong Yang, Ji Li, Bei Tan, Jia Ming Qian
OBJECTIVE: The aim of this study was to explore the long-term risk of infection in patients with Crohn's disease (CD) on infliximab (IFX) therapy. METHODS: All CD patients treated with IFX were recruited from January 2008 to December 2015. Their characteristics and infectious events during IFX therapy were prospectively collected, and the risk of infection was evaluated using Cox regression. RESULTS: Seventy CD patients receiving IFX were consecutively recruited...
July 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28633544/medical-versus-surgical-management-of-penetrating-crohn-s-disease-the-current-situation-and-future-perspectives
#15
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
#16
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 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28609262/image-diagnosis-iliopsoas-abscess-from-crohn-disease
#17
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
#18
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
#19
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...
September 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28573532/-surgical-strategy-to-save-ileoanal-pouch-reconstruction
#20
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...
July 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
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