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https://www.readbyqxmd.com/read/28644182/incidence-and-management-of-recurrence-in-patients-with-crohn-s-disease-who-have-undergone-intestinal-resection-the-practicrohn-study
#1
Eugeni Domènech, Valle Garcia, Marisa Iborra, Ana Gutiérrez, Santiago García-López, María D Martín Arranz, Esther Garcia-Planella, Marta Calvo, Luisa Castro, Miguel Mínguez, Carlos Taxonera, Berta Juliá, Luis Cea-Calvo, Cristina Romero, Manuel Barreiro-de Acosta
BACKGROUND: More than 50% of patients with Crohn's disease require intestinal resection at least once. Postoperative recurrence (POR) is almost uniform if prophylactic treatment is not started early. Endoscopic monitoring is generally advised. We studied the incidence and management of recurrence in patients who had undergone intestinal resection. METHODS: Practicrohn was an observational retrospective study performed in 26 Spanish hospitals including patients aged ≥18 years who underwent Crohn's disease-related ileocolonic resection between January 2007 and December 2010...
June 20, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28634703/isoperistaltic-versus-antiperistaltic-side-to-side-anastomosis-after-right-laparoscopic-hemicolectomy-for-cancer-isovanti-trial-study-protocol-for-a-randomised-clinical-trial
#2
N Ibañez, J Abrisqueta, J Luján, Q Hernández, P Parrilla
BACKGROUND: It is believed that loosing ileocecal valve is well tolerated in patients who do not have short bowel syndrome or Crohn disease. From the hypothesis of colonic peristalsis and transit is regulated by that ileocecal valvular mechanism, we try to find out if the creation of a new pseudo-valvular mechanism as antiperistaltic anastomosis could be considered after right hemicolectomy can cause any short- or long-term changes in gastrointestinal habits. PURPOSE: The purpose of the study at primary endpoint is to compare early (occurring within 30 days of surgery) and late (occurring during the follow-up) postoperative complications between both groups The purpose of the study at secondary endpoint is to compare intraoperative and postoperative events between experimental and control groups in terms of operating time, first oral tolerance day, first flatus and faeces, length of hospital stay and orocecal transit; comparing rates of gastrointestinal life quality and comparing mortality rates between both groups...
June 21, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28630777/magnetic-resonance-enterography-findings-of-intestinal-beh%C3%A3-et-disease-in-a-child
#3
Tommaso D'Angelo, Romina Gallizzi, Claudio Romano, Giuseppe Cicero, Silvio Mazziotti
Behçet's disease (BD) is a multisystem disorder of unknown aetiology, characterized by recurrent oral ulcers, genital ulcers, uveitis, skin lesions, and pathergy. Gastrointestinal disease outside the oral cavity is well recognized and usually takes the form of small intestinal ulcers, with the most significant lesions frequently occurring in the ileocaecal region. Symptoms usually include nausea, vomiting, colicky abdominal pain, and change in bowel habit and it is not unusual that patients may present late, with life-threatening complications requiring surgery...
2017: Case Reports in Radiology
https://www.readbyqxmd.com/read/28630623/strategies-for-preventing-endoscopic-recurrence-of-crohn-s-disease-1-year-after-surgery-a-network-meta-analysis
#4
REVIEW
Jin-Shan Feng, Jin-Yu Li, Xiu-Yan Chen, Zheng Yang, Shang-Hai Li
OBJECTIVE: To assess the benefits of different treatments that aim to prevent the endoscopic recurrence of Crohn's disease (CD) after ileal resection. METHODS: Randomized controlled trials (RCTs) were searched from MEDLINE, Embase, and the Cochrane Central Database. All the included RCTs with an endoscopic recurrence outcome which was defined as Rutgeerts' score ≥ i2 have a duration of more than 1 year. The quality of the included RCTs was assessed by the Cochrane Risk of Bias Tool...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28630242/tumour-necrosis-factor-tnf-inhibitor-induced-isolated-pleural-granulomas-a-rare-adverse-effect
#5
Muhammad Sajawal Ali, Rose Franco, Dheeraj Dhotre, Nagarjun Rao
A 53-year-old man with a history of Crohn's disease on infliximab, presented with several weeks of cough and dyspnoea. He had a right-sided pleural effusion, found to be exudative with lymphocytic predominance. He underwent right-sided video-assisted thoracic surgery (VATS) with biopsies and pleurodesis. Histopathology showed pleural-based non-caseating granulomas with unremarkable lung parenchyma. Cultures were only positive for Propionibacterium acnes 8 months later, he was found to have a left-sided exudative, lymphocytic predominant pleural effusion...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28630047/update-on-anti-tumor-necrosis-factor-agents-and-other-new-drugs-for-inflammatory-bowel-disease
#6
REVIEW
Benjamin L Cohen, David B Sachar
The treatment of inflammatory bowel disease (IBD)-ulcerative colitis (UC) and Crohn's disease (CD)-has evolved beyond surgery with the introduction of biologic agents, primarily antibodies against mediators of inflammation and cell attraction. Anti-tumor necrosis factor (TNF) agents have been the first line treatment for moderate to severe ulcerative colitis and Crohn's disease for more than 15 years. During that time much has been learnt about how best to use these agents. This review will assess the evidence on how to optimize the use of anti-TNF agents; when and how to start treatment; how to monitor treatment and when to de-escalate it; and the potential adverse effects of these drugs...
June 19, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28627592/triptolide-exerts-protective-effects-against-fibrosis-following-ileocolonic-anastomosis-by-mechanisms-involving-the-mir-16-1-hsp70-pathway-in-il-10-deficient-mice
#7
Hong-Wei Hou, Jin-Min Wang, Dong Wang, Rong Wu, Zhen-Ling Ji
Surgeries, particularly ileocecal resection (ICR), are often required in the treatment of Crohn's disease (CD). However, recurrences are common for patients who undergo ICR, and anastomotic fibrosis is the main cause of re-operation. The present study aimed to investigate the therapeutic effects of triptolide (TPL) in ameliorating fibrosis following ileocolonic anastomosis. A model of IL‑10‑/‑ mice undergoing ICR was used to study postsurgical inflammation and fibrosis of anastomosis. For this purpsose, interleukin (IL)‑10‑/‑ mice were randomly divided into 3 groups as follows: the control group, the saline‑treated group subjected to ICR (ST‑ICR) and the TPL‑treated group subjected to ICR (TT‑ICR)...
June 9, 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/28622435/single-port-laparoscopic-ileocaecal-resection-for-crohn-s-disease-a-multicentre-comparison-with-multi-port-laparoscopy
#8
Michele Carvello, E Joline de Groof, Anthony de Buck van Overstraeten, Matteo Sacchi, Albert M Wolthuis, Christianne J Buskens, André D'Hoore, Willem A Bemelman, Antonino Spinelli
BACKGROUND AND AIMS: Single port (SP) ileocecal resection (ICR) is an established technique but there are no large studies comparing SP and multi-port (MP) laparoscopic surgery in Crohn's disease (CD). The aim of this study was to compare postoperative pain scores and analgesia requirements after SP and MP laparoscopic ICR for CD. METHODS: This was a retrospective study of patients undergoing SP or MP ICR for CD in three tertiary referral centres from February 1999-October 2014...
June 16, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28614561/association-of-preoperative-anti-tumor-necrosis-factor-therapy-with-adverse-postoperative-outcomes-in-patients-undergoing-abdominal-surgery-for-ulcerative-colitis
#9
Audrey S Kulaylat, Afif N Kulaylat, Eric W Schaefer, Andrew Tinsley, Emmanuelle Williams, Walter Koltun, Christopher S Hollenbeak, Evangelos Messaris
Importance: Despite the increasing use of anti-tumor necrosis factor (TNF) therapy in ulcerative colitis, its effects on postoperative outcomes remain unclear, with many patients requiring surgical intervention despite optimal medical management. Objective: To assess the association of preoperative use of anti-TNF agents with adverse postoperative outcomes. Design, Setting, and Participants: This analysis used insurance claims data from a large national database to identify patients 18 years or older with ulcerative colitis...
June 14, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28608250/the-efficacy-of-active-drainage-for-preventing-postoperative-organ-space-surgical-site-infections-in-patients-with-crohn-s-disease
#10
Ryo Ikeshima, Tsunekazu Mizushima, Hidekazu Takahashi, Naotsugu Haraguchi, Junichi Nishimura, Taishi Hata, Chu Matsuda, Masakazu Ikenaga, Kiyokazu Nakajima, Hirofumi Yamamoto, Kohei Murata, Yuichiro Doki, Masaki Mori
PURPOSE: Patients with Crohn's disease (CD) show a higher incidence of surgical site infections (SSIs) after bowel resection in comparison to other patient populations because CD patients commonly suffer from anemia, malnutrition, and immunosuppression. In comparison to conventional passive drainage, active drainage using a closed-suction drain reportedly reduces postoperative wound-related complications in several diseases. In the present study, we aimed to investigate the incidence of SSI and to identify the risk factors for SSI in patients with CD...
June 12, 2017: Surgery Today
https://www.readbyqxmd.com/read/28606755/recommendations-of-the-spanish-working-group-on-crohn-s-disease-and-ulcerative-colitis-geteccu-on-the-monitoring-prevention-and-treatment-of-post-operative-recurrence-in-crohn-s-disease
#11
Eugeni Domènech, Antonio López-Sanromán, Pilar Nos, Maribel Vera, María Chaparro, María Esteve, Javier P Gisbert, Míriam Mañosa
Despite the availability of new, powerful drugs for Crohn's disease, a significant proportion of patients will undergo an intestinal resection to control the disease as it develops. In the absence of an effective preventative treatment, the appearance of new intestinal lesions after surgery for Crohn's disease is the norm; this is known as post-operative recurrence and may appear very early on, even a few weeks after the surgical resection. Furthermore, the drugs that are currently available for the prevention of post-operative recurrence have a limited effect; up to 50% of cases present recurrent Crohn's disease activity despite the preventative treatment, which may require further surgery with the consequent loss of intestinal function, leading some patients to suffer from short bowel syndrome as an irreversible complication...
June 9, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28603049/ethnicity-influences-phenotype-and-outcomes-in-inflammatory-bowel-disease-a-systematic-review-and-meta-analysis-of-population-based-studies
#12
Haiyun Shi, Alexander N Levy, Hirsh D Trivedi, Francis Kl Chan, Siew C Ng, Ashwin N Ananthakrishnan
INTRODUCTION: Inflammatory bowel diseases (IBD; Crohn's disease (CD), ulcerative colitis (UC)) are global diseases. Similarities and differences in disease presentation and outcomes across different geographic regions and ethnic groups have not been compared previously. METHODS: We performed a systematic review and meta-analysis of population based cohort studies examining the phenotype and outcome of IBD across ethnic groups, categorized as Whites, Blacks, Hispanics and Asians...
June 8, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28601423/crohn-disease-epidemiology-diagnosis-and-management
#13
REVIEW
Joseph D Feuerstein, Adam S Cheifetz
Crohn disease is a chronic idiopathic inflammatory bowel disease condition characterized by skip lesions and transmural inflammation that can affect the entire gastrointestinal tract from the mouth to the anus. For this review article, we performed a review of articles in PubMed through February 1, 2017, by using the following Medical Subject Heading terms: crohns disease, crohn's disease, crohn disease, inflammatory bowel disease, and inflammatory bowel diseases. Presenting symptoms are often variable and may include diarrhea, abdominal pain, weight loss, nausea, vomiting, and in certain cases fevers or chills...
June 7, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28601328/correlation-between-fecal-calprotectin-and-inflammation-in-the-surgical-specimen-of-crohn-s-disease
#14
Salvador Pous-Serrano, Matteo Frasson, Elena Cerrillo, Belén Beltrán, Marisa Iborra, David Hervás, Eduardo García-Granero, Pilar Nos
BACKGROUND: An accurate assessment of the inflammatory activity is crucial to establish the most appropriate treatment in Crohn's disease (CD). The present study aimed to evaluate the utility of preoperative fecal calprotectin (FC) measurement in small bowel CD and its relationship with inflammatory activity in surgical pathology specimens. METHODS: This was a prospective observational study including all the patients with small bowel CD operated on at our center between March 2011 and September 2013...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28598298/efficacy-of-exclusive-enteral-nutrition-in-complicated-crohn-s-disease
#15
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/28594329/updating-predictors-of-endoscopic-recurrence-after-ileocolic-resection-for-crohn-disease
#16
Sara Monteiro, Tiago Cúrdia Gonçalves, Pedro Boal Carvalho, Maria João Moreira, José Cotter
BACKGROUND/AIMS: Identifying predictors of endoscopic recurrence (ER) has become very important to guide the decision of postoperative strategy. This study aimed to determine the rate of endoscopic recurrence until 12 months after ileocolic resection for Crohn disease (CD) in a cohort and identify its possible predictors. MATERIALS AND METHODS: We conducted a retrospective single-center study that included patients with CD who underwent ileocolic resection between 2003 and 2014...
June 7, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28593437/incidence-and-clinical-outcomes-of-inflammatory-bowel-disease-in-south-korea-2011-2014-a-nationwide-population-based-study
#17
Yoon Suk Jung, Minkyung Han, Won Ho Kim, Sohee Park, Jae Hee Cheon
BACKGROUND: The incidence of inflammatory bowel disease (IBD) is increasing in East Asia; however, population-based data from this region are lacking. AIM: We conducted a nationwide, population-based study to examine the incidence and disease course of IBD in South Korea. METHODS: Using the National Health Insurance claims data, we collected data on patients diagnosed with IBD [10,049 with ulcerative colitis (UC) and 5595 with Crohn's disease (CD)] from 2011 to 2014...
June 7, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28590344/the-characteristics-and-long-term-outcomes-of-pediatric-crohn-s-disease-patients-with-perianal-disease
#18
Yonatan Herman, Firas Rinawi, Benjamin Rothschild, Osnat Nir, Raanan Shamir, Amit Assa
BACKGROUND: Data on the outcomes of children with perianal Crohn's disease are limited. We aimed to assess phenotypic features at diagnosis and long-term disease-specific outcomes of this phenotype. METHODS: The medical records of 296 pediatric onset patients with Crohn's disease, diagnosed from 2001 to 2015, were reviewed retrospectively. Baseline characteristics included age, sex, severity indices, laboratory data, endoscopic findings, and anthropometric measurements...
June 5, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28589045/recurrent-enterolithiasis-small-bowel-obstruction-a-case-seldom-described
#19
Ashish Lal Shrestha, Pradita Shrestha
BACKGROUND: Enterolithiasis of the small bowel is a rare phenomenon in humans although it has been frequently described in equines. Primary enteroliths have been described including those occurring secondary to conditions like Crohn's disease, small bowel diverticula, tuberculous or postoperative strictures, and blind loops but those occurring in an otherwise normal gut are exceedingly rare. Of even greater rarity is a recurrent small bowel enterolith presenting with obstruction. This may be the first report of such kind...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28587182/preoperative-nutritional-conditioning-of-crohn-s-patients-systematic-review-of-current-evidence-and-practice
#20
Fabian Grass, Basile Pache, David Martin, Dieter Hahnloser, Nicolas Demartines, Martin Hübner
Crohn's disease is an incurable and frequently progressive entity with major impact on affected patients. Up to half of patients require surgery in the first 10 years after diagnosis and over 75% of operated patients require at least one further surgery within lifetime. In order to minimize surgical risk, modifiable risk factors such as nutritional status need to be optimized. This systematic review on preoperative nutritional support in adult Crohn's patients between 1997 and 2017 aimed to provide an overview on target populations, screening modalities, routes of administration, and expected benefits...
June 1, 2017: Nutrients
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