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Complications of Crohn's Disease

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https://www.readbyqxmd.com/read/27922024/improvements-in-the-long-term-outcome-of-crohn-s-disease-over-the-past-two-decades-and-the-relation-to-changes-in-medical-management-results-from-the-population-based-ibdsl-cohort
#1
Steven F G Jeuring, Tim R A van den Heuvel, Limmie Y L Liu, Maurice P Zeegers, Wim H Hameeteman, Mariëlle J L Romberg-Camps, Liekele E Oostenbrug, Ad A M Masclee, Daisy M A E Jonkers, Marieke J Pierik
OBJECTIVES: Medical treatment options and strategies for Crohn's disease (CD) have changed over the past decades. To assess its impact, we studied the evolution of the long-term disease outcome in the Dutch Inflammatory Bowel Disease South Limburg (IBDSL) cohort. METHODS: In total, 1,162 CD patients were included. Three eras were distinguished: 1991-1998 (n=316), 1999-2005 (n=387), and 2006-2011 (n=459), and patients were followed until 2014. Medication exposure and the rates of hospitalization, surgery, and phenotype progression were estimated using Kaplan-Meier survival analyses and compared between eras by multivariable Cox regression models...
December 6, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27920850/choledochoduodenal-fistula-in-the-setting-of-crohn-s-disease
#2
Shane Knipping, Ravi Rajpoot, Roozbeh Houshyar
Of all the spontaneous fistulas that occur between the extrahepatic biliary system and the intestine, a choledochoduodenal fistula is rarely seen. When it does occur, it is most often secondary to a perforated duodenal ulcer, choledocholithiasis, or cholelithiasis. It may also be seen following complications related to iatrogenic injury or tuberculosis. Generally, choledochoduodenal fistulas are asymptomatic, but may present with vague abdominal pain, fever, and other symptoms related to cholangitis. As a result, they can be difficult to diagnose clinically before imaging is obtained...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27915373/risk-factors-associated-with-postoperative-morbidity-in-over-500-colovesical-fistula-patients-undergoing-colorectal-surgery-a-retrospective-cohort-study-from-acs-nsqip-database
#3
H Hande Aydinli, Cigdem Benlice, Gokhan Ozuner, Emre Gorgun, Maher A Abbas
PURPOSE: The aim of this study was to evaluate the impact of various factors on 30-day postoperative morbidity in patients who underwent colorectal surgery (CRS) for colovesical fistula (CVF) in the elective and emergency settings. METHODS: Patients who underwent CRS for CVF between 2005 and 2013 were identified from the American College of Surgeons National Surgical Quality Improvement Program database by using current procedural terminology codes. Demographics, perioperative, and operative factors were assessed and compared between two groups classified according to the presence or absence of postoperative complications...
December 3, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27914655/crohn-s-disease
#4
REVIEW
Joana Torres, Saurabh Mehandru, Jean-Frédéric Colombel, Laurent Peyrin-Biroulet
Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract, with increasing incidence worldwide. Crohn's disease might result from a complex interplay between genetic susceptibility, environmental factors, and altered gut microbiota, leading to dysregulated innate and adaptive immune responses. The typical clinical scenario is a young patient presenting with abdominal pain, chronic diarrhoea, weight loss, and fatigue. Assessment of disease extent and of prognostic factors for complications is paramount to guide therapeutic decisions...
November 30, 2016: Lancet
https://www.readbyqxmd.com/read/27903285/prognostic-biomarkers-to-identify-patients-destined-to-develop-severe-crohn-s-disease-who-may-benefit-from-early-biological-therapy-protocol-for-a-systematic-review-meta-analysis-and-external-validation
#5
Steve Halligan, Darren Boone, Gauraang Bhatnagar, Tariq Ahmad, Stuart Bloom, Manuel Rodriguez-Justo, Stuart A Taylor, Susan Mallett
BACKGROUND: It is believed increasingly that patients with severe Crohn's disease are best treated early with biological therapy, which may ameliorate subsequent disease course and diminish long-term complications. However, we cannot predict currently which new presentations of Crohn's disease are destined to develop severe disease so treatment cannot be targeted to the most appropriate patients. Accordingly, via systematic review and meta-analysis we aim to identify if biomarkers of disease activity are able to predict development of severe disease...
December 1, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27900523/liver-test-abnormalities-predict-complicated-disease-behaviour-in-patients-with-newly-diagnosed-crohn-s-disease
#6
Jessika Barendregt, Myrthe de Jong, Jeoffrey J Haans, Bart van Hoek, James Hardwick, Roeland Veenendaal, Andrea van der Meulen, Nidhi Srivastava, Rogier Stuyt, Jeroen Maljaars
BACKGROUNDS: In coeliac disease, the prevalence of liver test abnormalities (LTAs) is higher in patients with more severe mucosal inflammation. In Crohn's disease, prognosis is related to the severity of mucosal inflammation. AIM: The aim of this study was to investigate whether the presence of LTA predicts the occurrence of complicated disease behaviour in newly diagnosed Crohn's disease. METHODS: A retrospective cohort study was performed in patients newly diagnosed with Crohn's disease between 2002 and 2011...
November 29, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27895873/value-of-computerized-tomography-enterography-in-predicting-crohn-s-disease-activity-correlation-with-crohn-s-disease-activity-index-and-c-reactive-protein
#7
Eun Kyung Park, Na Yeon Han, Beom Jin Park, Deuk Jae Sung, Sung Beom Cho, Yoon Tae Jeen, Bora Keum, Min Ju Kim
BACKGROUND: The accurate evaluation of Crohn's disease activity is important for the treatment of the disease and for monitoring the response. Computerized tomography (CT) enterography is a useful imaging modality that reflects enteric inflammation, as well as extramural complications. OBJECTIVES: The aim of this study was to evaluate the correlation between CT enterographic (CTE) findings of active Crohn's disease and the Crohn's disease activity index (CDAI) and C-reactive protein (CRP)...
October 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
https://www.readbyqxmd.com/read/27893544/visceral-adiposity-genetic-susceptibility-and-risk-of-complications-among-individuals-with-crohn-s-disease
#8
Kimberley W J Van Der Sloot, Amit D Joshi, Danielle R Bellavance, Katherine K Gilpin, Kathleen O Stewart, Paul Lochhead, John J Garber, Cosmas Giallourakis, Vijay Yajnik, Ashwin N Ananthakrishnan, Behrooz Z Alizadeh, Ramnik J Xavier, Hamed Khalili
INTRODUCTION: Adipose tissue in mesenteric fat plays a key role in systemic and luminal inflammation. However, little is known about the role of visceral adipose tissue (VAT) and its interaction with genetic predisposition in Crohn's disease (CD) progression. METHODS: Our study population included patients with CD enrolled in Prospective Registry in Inflammatory Bowel Disease Study at Massachusetts General Hospital (PRISM). VAT volume was measured from computed tomography using Aquarius 3D...
November 22, 2016: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/27890312/variables-associated-with-loss-of-ileoanal-pouches-constructed-in-childhood
#9
Khaled Abdelaal, Bruce Jaffray
AIMS: To quantify the incidence of loss of an ileoanal pouch in children and to identify variables associated this event. METHODS: Logistic regression of possible explanatory variables: age, sex, indication for procto-colectomy, pre-operative continence status, use of immunosuppressive drugs, open or laparoscopic surgery, number of stages, anastomotic leak, operative complication excluding anastomotic leak, performance of revisional surgery, albumin concentration and platelet count at time of surgery, rank order in series...
November 13, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27883259/the-association-between-intensified-medical-treatment-time-to-surgery-and-ileocolic-specimen-length-in-crohn-s-disease
#10
E Joline de Groof, Tjibbe J Gardenbroek, Christianne J Buskens, Pieter J Tanis, Cyriel Y Ponsioen, Geert R A M D'Haens, Willem A Bemelman
BACKGROUND: During the last decade, treatment protocols have changed for patients with ileocolic Crohn's disease. Anti-TNF has become part of standard medical treatment, usually in a step-up approach. The aim was to analyse if improved medical treatment has resulted in more limited ileocolic resections and a longer interval between diagnosis and surgery. METHODS: Patients undergoing ileocolic resection for Crohn's disease were included (1999-2014). Patient characteristics were compared to the results of a population based study (between 2004-2010) previously performed in the catchment area of the present tertiary referral centre...
November 24, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27875505/radiologic-predictors-of-surgery-in-newly-diagnosed-pediatric-crohn-disease-patients
#11
Damien Parker, Boaz Karmazyn, Steven J Steiner
OBJECTIVES: The aim of the present study was to assess whether small bowel imaging conducted at the time of diagnosis could be used as a predictor of small bowel surgical intervention in a population of pediatric patients with Crohn disease (CD). METHODS: A retrospective analysis of small bowel imaging within 30 days of diagnosis of pediatric CD was conducted. Patients were divided into 2 groups based on small bowel imaging: those with no or minor abnormalities (71%) and those with more extensive or obstructive abnormalities (29%)...
December 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27867692/osteonecrosis-of-both-knees-in-a-woman-with-crohn-s-disease
#12
Mara Barbosa, José Cotter
Osteonecrosis is a very rare complication of Crohn's disease (CD). It is not clear if it is related to corticosteroid therapy or if it occurs as an extraintestinal manifestation of inflammatory bowel disease. We present the case of a patient with CD who presented with osteonecrosis of both knees. A 22 years old woman was diagnosed with CD in April 2012 (Montreal Classification A2L1 + L4B3p). She was started on prednisolone (40 mg/d), azathioprine (100 mg/d) and messalazine (3 g/d). In July 2012, due to active perianal disease, infliximab therapy was initiated...
November 6, 2016: World Journal of Gastrointestinal Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27864666/evaluation-of-serum-trace-element-levels-and-superoxide-dismutase-activity-in-patients-with-inflammatory-bowel-disease-translating-basic-research-into-clinical-application
#13
Erfan Mohammadi, Durdi Qujeq, Hassan Taheri, Karimollah Hajian-Tilaki
The relationship of minerals and trace elements with inflammatory bowel disease (IBD) is complex. Alterations in their metabolism can be induced by the diseases and their complications. To study the role of trace elements in IBD patients' serum zinc and copper and their related enzymes, including superoxide dismutase (SOD), activity were measured in patients with IBD patients as well as in healthy subjects. In addition, the correlation between serum trace element levels, albumin, total protein, urea level, copper/zinc ratio, and disease activity (DA) was determined in these subjects...
November 18, 2016: Biological Trace Element Research
https://www.readbyqxmd.com/read/27858582/long-term-outcome-of-laparoscopic-duhamel-procedure-for-extended-hirschsprung-s-disease
#14
Cécile O Muller, Guillaume Rossignol, Louise Montalva, Jerome Viala, Christine Martinez-Vinson, Alexis Mosca, Dominique Berrebi, Arnaud Bonnard
BACKGROUND: The aim of our study was to report our experience in extended Hirschsprung's disease (HD) in children operated on by laparoscopy. PATIENTS AND METHODS: Retrospective data collection from a single center from 1991 to 2013 concerned extended forms of HD operated on by laparoscopic Duhamel procedure and included extension of aganglionosis, comorbidities, short and late postoperative outcome, and results of endoscopy when performed. RESULTS: Thirty patients presented an extended form of aganglionosis: 5 involving the transverse colon, 10 the right colon, and 15 the ileum (median length = 15 cm, range 1-60)...
November 18, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27832426/long-term-outcomes-in-indeterminate-colitis-patients-undergoing-ileal-pouch-anal-anastomosis-function-quality-of-life-and-complications
#15
Katharine L Jackson, Luca Stocchi, Leonardo Duraes, Ahmet Rencuzogullari, Ana E Bennett, Feza H Remzi
INTRODUCTION: It is uncertain whether the outcomes of patients with indeterminate colitis (IC) undergoing ileal pouch-anal anastomosis (IPAA) deteriorate over time. The aim of this study was to determine the long-term pouch function, quality of life, complications, and incidence of Crohn's disease after IPAA for patients with IC compared to ulcerative colitis (UC). METHODS: A case matched analysis was performed on patients undergoing IPAA for pathologically confirmed IC or UC, between 1985 and 2014...
November 10, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27831543/a-distinct-colon-derived-breath-metabolome-is-associated-with-inflammatory-bowel-disease-but-not-its-complications
#16
Florian Rieder, Satya Kurada, David Grove, Frank Cikach, Rocio Lopez, Nishaben Patel, Amandeep Singh, Naim Alkhouri, Bo Shen, Aaron Brzezinski, Mark Baker, Claudio Fiocchi, Raed A Dweik
OBJECTIVES: The accuracy of available noninvasive biomarkers for diagnosis, stratification, and prediction of inflammatory bowel disease (IBD) courses is limited. We analyzed volatile organic compounds (VOCs) in the breath of IBD patients and controls for diagnosis and differentiation of IBD as well as their link with disease location, activity, and phenotype. METHODS: A prospective study of diagnostic testing was conducted, recruiting Crohn's disease (CD), ulcerative colitis (UC), other inflammatory gastrointestinal diseases (OGDs), and healthy controls (HCs), as well as subjects with ileal pouch anal anastomosis (IPAA)...
November 10, 2016: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/27829602/a-case-of-crohn-s-disease-complicated-with-simultaneous-double-cancers-of-the-small-bowel
#17
Nao Obara, Kazutaka Koganei, Kenji Tatsumi, Ryo Futatsuki, Hirosuke Kuroki, Kyoko Yamada, Katsuhiko Arai, Akira Sugita, Hiroyuki Hayashi, Tsuneo Fukushima
A case of Crohn's disease complicated with simultaneous double cancers of the small bowel is reported. The patient is a 66-year-old man who had suffered from Crohn's disease for 20 years. He underwent surgery to identify the source of repeated episodes of intestinal obstruction. Two short segments of strictures and proximal dilatations were found in the distal ileum. Therefore, we performed an en bloc resection of the two stenotic sections instead of strictureplasty. Histological examination of the resected specimen revealed not only Crohn's disease but also a well-differentiated adenocarcinoma within each of the two strictures...
2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/27818466/significant-contribution-of-trpc6-channel-mediated-ca-2-influx-to-the-pathogenesis-of-crohn-s-disease-fibrotic-stenosis
#18
Lin Hai Kurahara, Keizo Hiraishi, Miho Sumiyoshi, Mayumi Doi, Yaopeng Hu, Kunihiko Aoyagi, Yuwen Jian, Ryuji Inoue
Intestinal fibrosis is an intractable complication of Crohn's disease (CD), and, when occurring excessively, causes severe intestinal obstruction that often necessitates surgical resection. The fibrosis is characterized by an imbalance in the turnover of extracellular matrix (ECM) components, where intestinal fibroblasts/myofibroblasts play active roles in ECM production, fibrogenesis and tissue remodeling, which eventually leads to the formation of stenotic lesions. There is however a great paucity of knowledge about how intestinal fibrosis initiates and progresses, which hampers the development of effective pharmacotherapies against CD...
2016: Journal of Smooth Muscle Research, Nihon Heikatsukin Gakkai Kikanshi
https://www.readbyqxmd.com/read/27814421/metastatic-crohn-disease-clinically-reminiscent-of-erythema-nodosum-on-the-right-leg
#19
Hyun C Park, Hyun W Kim, Chan G Park, Joo Y Ko
Cutaneous manifestations are well-recognized complications of Crohn disease (CD) that can be divided into disease-specific and reactive conditions. One of the most common reactive conditions is erythema nodosum (EN), which presents as subcutaneous tender nodules most often on the legs. On the other hand, metastatic Crohn disease (MCD) is a rare cutaneous manifestation of CD defined as the presence of noncaseating granulomas that are not contiguous with the gastrointestinal (GI) tract. The clinical presentation of MCD is variable; however, lesions often are located on the legs and genital region...
September 2016: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/27812365/shared-genetic-etiology-of-autoimmune-diseases-in-patients-from-a-biorepository-linked-to-de-identified-electronic-health-records
#20
Nicole A Restrepo, Mariusz Butkiewicz, Josephine A McGrath, Dana C Crawford
: Autoimmune diseases represent a significant medical burden affecting up to 5-8% of the U.S. POPULATION: While genetics is known to play a role, studies of common autoimmune diseases are complicated by phenotype heterogeneity, limited sample sizes, and a single disease approach. Here we performed a targeted genetic association study for cases of multiple sclerosis (MS), rheumatoid arthritis (RA), and Crohn's disease (CD) to assess which common genetic variants contribute individually and pleiotropically to disease risk...
2016: Frontiers in Genetics
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