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Nan Lan, Luca Stocchi, Jean H Ashburn, Tracy L Hull, Scott R Steele, Conor P Delaney, Bo Shen
BACKGROUND & AIMS: Few studies have compared endoscopic balloon dilation (EBD) with ileocolic resection (ICR) in the treatment of primary ileocolic strictures in patients with Crohn's disease (CD). METHODS: We performed a retrospective study to compare post-procedure morbidity and surgery-free survival among 258 patients with primary stricturing ileo (colic) CD (B2, L1, or L3) initially treated with primary EBD (n=117) or ICR (n=258) from 2000 through 2016. Patients with penetrating disease were excluded from the study...
March 2, 2018: Clinical Gastroenterology and Hepatology
Hamid Yousuf, Umair Aleem, Roisin Egan, Pardeep Maheshwari, Jafaar Mohamad, Deidre McNamara
BACKGROUND: Approximately 10% of Crohn's disease (CD) patients have this disease affecting the small bowel (SB) beyond the reach of Ileo-colonoscopy. Capsule endoscopy (SBCE) is the recommended investigation for SB disease. An accurate and inexpensive biomarker would help identify at-risk patients. AIM: To examine the efficacy of faecal calprotectin (FC) and C-reactive protein (CRP) as predictors of SBCE findings in suspected and known CD. METHODS: A prospective observational study...
February 21, 2018: Digestive Diseases
N Jewel Samadder, Scott K Kuwada, Kenneth M Boucher, Kathryn Byrne, Priyanka Kanth, Wade Samowitz, David Jones, Sean V Tavtigian, Michelle Westover, Therese Berry, Kory Jasperson, Lisa Pappas, Laurel Smith, Danielle Sample, Randall W Burt, Deborah W Neklason
Importance: Patients with familial adenomatous polyposis (FAP) are at markedly increased risk for colorectal polyps and cancer. A combination of sulindac and erlotinib led to a 71% reduction in duodenal polyp burden in a phase 2 trial. Objective: To evaluate effect of sulindac and erlotinib on colorectal adenoma regression in patients with FAP. Design, Setting, and Participants: Prespecified secondary analysis for colorectal adenoma regression was carried out using data from a double-blind, randomized, placebo-controlled trial, enrolling 92 patients with FAP, conducted from July 2010 to June 2014 in Salt Lake City, Utah...
February 8, 2018: JAMA Oncology
Satoshi Nishiwada, Shinji Nakamura, Tetsuya Tanaka, Yuki Kirihataya, Daiki Nezu, Nobuhiro Sawa, Naoki Fujita, Haruka Ikegami, Atsushi Yoshimura
INTRODUCTION: Entero-enteric fistulas are rare complications that occur in patients with inflammatory bowel disease and other intestinal diseases. In this report, we present an ileo-ileal fistula accompanied by severe malnutrition caused by strangulated ileus surgery while preserving the ischemic ileum in a very elderly patient. CASE PRESENTATION: A 90-year-old woman underwent emergency surgery without bowel resection for strangulated ileus in another hospital. Minor abdominal pain and slight fever persisted after surgery...
January 27, 2018: International Journal of Surgery Case Reports
Naoki Aomatsu, Yasutake Uchima, Chihoko Nobori, Shigeaki Kurihara, Yoshihito Yamakoshi, En Wang, Daisuke Nagashima, Toshiki Hirakawa, Takehiko Iwauchi, Junya Morimoto, Seika Tei, Kazunori Nakazawa, Kazuhiro Takeuchi
A 46-year old man presented with lower right quadrant abdominal pain caused by abdominal trauma. Abscess drainage was performed after the diagnosis of retroperitoneal abscess in the ileocecal portion of the colon. Type 2 advanced cancer was found in the cecum and ascending colon. Surgery was performed after improvement of inflammation. Considering the difficulty of curative resection for retroperitoneal invasion, we first performed ileo-transverse colon anastomosis. After surgery, the patient received FOLFOX with panitumumab(Pmab)as neoadjuvant chemotherapy...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Alberto Gomez Portilla, Victor Echenagusía, Iñaki Cendoya, Aintzane Maqueda, Eduardo López de Heredia
INTRODUCTION: Primary retroperitoneal parasitic leiomyoma (PRPL) with inguinal extension is a diagnostic-therapeutic challenge due to its uncertain etiopathogenesis and because it has been considered unresectable according to customary surgical techniques in some instances. The abdominoinguinal incision described by Karakousis in the 1980s allows a safe and radical approach for lower quadrants abdominopelvic tumors. OBJECTIVES: We present the case of a rare PRPL satisfactorily treated through Karakousis's approach...
January 9, 2018: International Journal of Surgery Case Reports
R Basuroy, C M O'Donnell, R Srirajaskanthan, J K Ramage
AIMS: Ileocolonic neuroendocrine tumours (NETs) are diagnosed as part of bowel cancer screening programmes (BCSP). The aim of this study was to identify and characterise NETs diagnosed within the English BCSP, a double screen programme using guaic faecal occult blood (FOBT) screening and colonoscopy, by interrogating the national colorectal screening database and validating the findings with individual BCSP centers. METHODS: The Exeter database was interrogated by running queries to identify participants with coded NETs (2006-2014)...
January 25, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Vipul Jairath, Ingrid Ordas, Guangyong Zou, Julian Panes, Jaap Stoker, Stuart A Taylor, Cynthia Santillan, Karin Horsthuis, Mark A Samaan, Lisa M Shackelton, Larry W Stitt, Pieter Hindryckx, Reena Khanna, William J Sandborn, Geert D'Haens, Brian G Feagan, Barrett G Levesque, Jordi Rimola
Background: Magnetic resonance enterography is increasingly utilized for assessment of luminal Crohn's disease activity. The Magnetic Resonance Index of Activity and the London Index are the most commonly used outcome measures in clinical trials. We assessed the reliability of these indices and several additional items. Methods: A consensus process clarified scoring conventions and identified additional items based on face validity. Four experienced radiologists evaluated 50 images in triplicate, in random order, at least 1 month apart, using a central image management system...
January 18, 2018: Inflammatory Bowel Diseases
Andreas Brandl, Wieland Raue, Felix Aigner, Maria Clara Arroyave, Johann Pratschke, Beate Rau
AIM: Extraperitoneal rectal resection combined with complete peritonectomy of the pelvis in patients with peritoneal metastases is associated with a high rate of morbidity and mortality due to anastomotic leakage (AL). Therefore, many centers tend to perform loop ileostomy to reduce the clinical impact of AL. The aim of this study was to analyze the need for protective stoma creation in this patient group to avoid major complications and mortality in the case of AL. METHOD: We analyzed 53 patients who underwent extraperitoneal rectal resection from 409 consecutive patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) at our department between January 1997 and December 2016...
January 6, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Jin-Min Chen, Tao Liu, Shan Gao, Xu-Dong Tong, Fei-Hong Deng, Biao Nie
AIM: To optimize the efficacy of noninvasive evaluations in monitoring the endoscopic activity of inflammatory bowel disease (IBD). METHODS: Fecal calprotectin (FC), clinical activity index (CDAI or CAI), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) were measured for 136 IBD patients. Also, FC was measured in 25 irritable bowel syndrome (IBS) patients that served as controls. Then, endoscopic activity was determined by other two endoscopists for colonic or ileo-colonic Crohn's disease (CICD) with the "simple endoscopic score for Crohn's disease" (SES-CD), CD-related surgery patients with the Rutgeerts score, and ulcerative colitis (UC) with the Mayo score...
December 14, 2017: World Journal of Gastroenterology: WJG
Steven Shamah, Judy Schneider, Burton I Korelitz
BACKGROUND AND AIMS: Ulcerative colitis (UC) patients with progression of their disease despite optimized medical therapy may warrant "curative" proctocolectomy with end ileostomy or ileo-anal pouch (IPAA) anastomosis. The aim of our study was to assess the incidence of later recurrent ileitis that lead to altering the initial diagnosis to Crohn's disease (CD). METHODS: A retrospective analysis was conducted on the inflammatory bowel disease database at Lenox Hill Hospital...
December 28, 2017: Digestive Diseases and Sciences
Judith E Baars, Ruben Theyventhiran, Patrick Aepli, Payal Saxena, Arthur J Kaffes
AIM: To evaluate the therapeutic role of double-balloon enteroscopy (DBE) in small bowel strictures and to propose a standard approach to small bowel strictures. METHODS: Systematic review of studies involving DBE in patients with small bowel strictures. Only studies limited to small bowel strictures were included and those with ileo-colonic strictures were excluded. RESULTS: In total 13 studies were included, in which 310 patients were dilated...
December 7, 2017: World Journal of Gastroenterology: WJG
Nikita Agrawal, David Ej Jones, Jessica K Dyson, Tim Hoare, Sharon A Melmore, Stephanie Needham, Nick P Thompson
We report a case of ileo-colonic Histoplasmosis without apparent respiratory involvement in a patient who had previously undergone an orthotopic liver transplant (OLT) for primary biliary cholangitis 15 years earlier. The recipient lived in the United Kingdom, a non-endemic region for Histoplasmosis. However, she had previously lived in rural southern Africa prior to her OLT. The patient presented with iron deficiency anaemia, diarrhoea, abdominal pain and progressive weight loss. She reported no previous foreign travel, however, it later became known that following her OLT she had been on holiday to rural southern Africa...
November 21, 2017: World Journal of Gastroenterology: WJG
Ryan P Werntz, Poone Shoureshi, Kyle Gillis, Akash Kapadia, David Jiang, Christopher Amling, John M Barry
OBJECTIVE: To create a simple neobladder and determine whether the double-limb U-Pouch (D-LUP) has the same capacity and compliance as a Studer or Camey I neobladder. To develop an orthotopic diversion that can be applied to robotic surgery with laboratory data supporting the concept. MATERIALS AND METHODS: Kidneys, ureters, bladders, and small intestine were obtained from pigs at the time of scheduled autopsy after completion of institutionally approved investigational trauma protocols...
December 1, 2017: Urology
Hamza Dergamoun, Zayd El Boukili El Makhoukhi
Bladder exstrophy is a malformation characterized by subumbilical anterior abdominal wall and anterior bladder wall deishence. It affects nearly 30.000-40.000 births per year, with a higher prevalence in boys. External continent urinary diversion creates a long-term outcome. However, it is not devoid of complications. We report the case of a 30-year old female patient who had undergone cystectomy with bladder replaced with ileo-caecal segment for bladder exstrophy 13 years earlier. She was followed up for 5 years and then lost to follow up...
2017: Pan African Medical Journal
A Lauro, R Cirocchi, N Cautero, A Dazzi, D Pironi, F M Di Matteo, A Santoro, L Pironi, A D Pinna
A systematic bibliographic research concerning patients operated on for SBS was performed: inclusion criteria were adult age, reconnection surgery and SBS < 100 cm. Autologous gastrointestinal reconstruction represented an exclusion criteria. The outcomes of interest were the rate of total parenteral nutrition (TPN) independence and the length of follow-up (minimum 1 year) after surgery. We reviewed our experience from 2003 to 2013 with minimum 1-year follow-up, dealing with reconnection surgery in 13 adults affected by < 100 cm SBS after massive small bowel resection: autologous gastrointestinal reconstruction was not feasible...
July 2017: Il Giornale di Chirurgia
Marco Clementi, Sara Colozzi, Mario Schietroma, Federico Sista, Andrea Della Penna, Alessandro Chiominto, Stefano Guadagni
Introduction: Extra-anastomotic intraluminal recurrence of the colon cancer after curative surgery was rarely reported but intraluminal ileal relapse has not been described to date.We report a case of intraluminal ileal tumor arising after curative right hemicolectomy that could be ascribed to an implantation of exfoliated cancer cells. Case report: A 71-years old man was admitted with no metastatic stenotic adenocarcinoma of the hepatic flexure and submitted, without preoperative bowel preparation, to right hemicolectomy using a "no-touch" technique...
November 2017: Annals of Medicine and Surgery
A Germain, A de Buck van Overstraeten, A Wolthuis, M Ferrante, S Vermeire, G Van Assche, A D'Hoore
AIM: Surgery for ileal pouch-anal anastomosis (IPAA) has evolved over time, especially since the introduction of laparoscopy. The aim of this retrospective study was to report the impact of surgical evolution on outcome over a period of 25 years. METHOD: All patients who had IPAA surgery for ulcerative colitis from 1990 to 2015 at the University Hospitals of Leuven were included. Patients were divided into three period arms (period A 1990-1999; period B 2000-2009; period C 2010-2015)...
February 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Ronen Ghinea, Shmuel Avital, Ephraim Katz, Baruch Shpitz, Ian White
BACKGROUND AND AIMS: Extended left hemicolectomy might be necessary for several indications. Once the resection is completed, it would be difficult or impossible to anastomose the transverse colon to the rectum due to the difficulty in mobilizing the transverse colon to reach for a tension-free rectal anastomosis. The aim of this report is to present the "Flip-Flop" technique to overcome this challenging situation. The procedure is based on a surgical technique published in the early 1960s to avoid permanent stoma after proctectomy and consists of changing the location of the right colon to reach the rectum...
October 28, 2017: International Journal of Colorectal Disease
Amir A Kimia, Scotty Williams, Peter N Hadar, Assaf Landschaft, John Porter, Richard G Bachur
BACKGROUND: Currant jelly stool is a late manifestation of intussusception and is rarely seen in clinical practice. Other forms of GI bleeding have not been thoroughly studied and little is known about their respective diagnostic values. OBJECTIVE: To assess the predictive value of GI bleeding (positive guaiac test, bloody stool and rectal bleeding in evaluation of intussusception. METHODS: We performed a retrospective cross-sectional study cohort of all children, ages 1month-6years of age, who had an abdominal ultrasound obtained evaluating for intussusception over 5year period...
October 18, 2017: American Journal of Emergency Medicine
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