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Complications of Crohn's Disease

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https://www.readbyqxmd.com/read/28434027/can-ultrasound-be-used-as-the-primary-imaging-in-children-with-suspected-crohn-disease
#1
Timothy L Tsai, Megan B Marine, Matthew R Wanner, Matthew L Cooper, Steven J Steiner, Fangqian Ouyang, S Gregory Jennings, Boaz Karmazyn
BACKGROUND: There is growing literature on the use of ultrasound (US) for evaluation of Crohn disease in adults, but few studies have been conducted on children. Several studies demonstrated high accuracy of US in the diagnosis of Crohn disease. Using US as the primary screening imaging modality for Crohn disease can reduce health care costs, the need for sedation and ionizing radiation exposure. OBJECTIVE: The aim of our study is to determine if US can be used for screening evaluation of pediatric Crohn disease...
April 22, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28430884/a-20-year-temporal-change-analysis-in-incidence-presenting-phenotype-and-mortality-in-the-dutch-ibdsl-cohort-can-diagnostic-factors-explain-the-increase-in-ibd-incidence
#2
Tim R A van den Heuvel, Steven F G Jeuring, Maurice P Zeegers, Dorien H E van Dongen, Anouk Wolters, Ad A M Masclee, Wim H Hameeteman, Marielle J L Romberg-Camps, Liekele E Oostenbrug, Marieke J Pierik, Daisy M Jonkers
Background: The aim was to study temporal changes in incidence, disease phenotype at diagnosis, and mortality of adult inflammatory bowel disease (IBD) patients in South Limburg, the Netherlands, diagnosed between 1991 and 2010. In addition, the 2010 IBD prevalence was estimated. Methods: A multi-faceted approach including hospital administrations, the national pathology registry, and general practitioners led to the identification of 1162 patients with Crohn's disease (CD), 1663 with ulcerative colitis (UC) and 84 with unclassified IBD (IBD-U)...
April 20, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28427855/outcome-of-medical-management-of-intraabdominal-abscesses-in-children-with-crohn-s-disease
#3
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/28426452/defining-the-most-appropriate-delivery-mode-in-women-with-inflammatory-bowel-disease-a-systematic-review
#4
Arthur Foulon, Jean-Louis Dupas, Charles Sabbagh, Julien Chevreau, Lionel Rebibo, Franck Brazier, Guillaume Bouguen, Jean Gondry, Mathurin Fumery
INTRODUCTION: High cesarean section (CS) rates are observed in patients with inflammatory bowel disease (IBD), but limited data are available to support this decision. We conducted a comprehensive review to evaluate the most appropriate mode of delivery in women with IBD according to disease phenotype and activity, as well as surgical history. MATERIALS AND METHODS: We searched MEDLINE (source PubMed) and international conference abstracts, and included all studies that evaluated digestive outcome after delivery in patients with IBD...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28421339/small-bowel-adenocarcinoma-complicating-crohn-s-disease-a-single-centre-experience-emphasizing-the-importance-of-screening-for-dysplasia
#5
Chloé Grolleau, Nicolas M Pote, Nathalie S Guedj, Magaly Zappa, Nathalie Theou-Anton, Yoram Bouhnik, Yves Panis, Dominique L Cazals-Hatem
Small bowel adenocarcinoma (SBA) complicating Crohn's disease (CD) is rare and generally found incidentally on surgical specimens. We report our experience in CD-associated SBA observed this last decade in a tertiary referral centre in order to update its incidence, clinical presentation and pathological features. All SBAs diagnosed in patients who underwent surgery for CD between 2006 and 2016 were retrospectively included. Clinico-pathological characteristics were reviewed, and follow-up was updated. SBA was diagnosed in 9 (1...
April 18, 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28416240/efficacy-of-tumour-necrosis-factor-antagonists-in-stricturing-crohn-s-disease-a-tertiary-center-real-life-experience
#6
Mariangela Allocca, Cristiana Bonifacio, Gionata Fiorino, Antonino Spinelli, Federica Furfaro, Luca Balzarini, Stefanos Bonovas, Silvio Danese
BACKGROUND: Stenosis is the most common complication of Crohn's disease (CD). Long-term outcome of patients receiving tumour necrosis factor (TNF) antagonists for such disease complication is poorly understood. METHODS: 51 CD patients (from July 2006 to November 2015) who had a diagnosis of small bowel or colonic stenosis, diagnosed by colonoscopy and/or MRI enterography, and were treated with TNF antagonists (adalimumab or infliximab) were enrolled. The primary outcome was to assess the rate of success of TNF antagonists on avoiding abdominal surgery for stricturing CD patients...
March 30, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28413638/serologic-testing-of-a-panel-of-five-antibodies-in-inflammatory-bowel-diseases-diagnostic-value-and-correlation-with-disease-phenotype
#7
Zhi-Zhi Wang, Ke Shi, Jie Peng
The aim of the present study was to evaluate the diagnostic value of five serological antibodies, perinuclear antineutrophil cytoplasmic antibody (pANCA), anti-Saccharomyces cerevisiae antibodies [ASCA; ASCA-immunoglobulin (IgG)and ASCA-IgA], Escherichia coli outer membrane porin C antibody (anti-OmpC) and CBir1 flagellin antibody for detection in inflammatory bowel diseases. Whether the antibody status correlated with the disease phenotype was also evaluated. Sera from 71 patients with Crohn's disease (CD), 41 patients with ulcerative colitis (UC), 78 patients with other gastrointestinal diseases and 31 healthy control subjects were investigated...
April 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28408997/endoscopic-balloon-dilatation-of-crohn-s-associated-intestinal-strictures-high-patient-satisfaction-and-long-term-efficacy
#8
Anna Rueda Guzmán, Jan Wehkamp, Andreas Kirschniak, Aline Naumann, Nisar P Malek, Martin Goetz
INTRODUCTION: Stricture formation is a common long-term complication of Crohn's disease. Endoscopic balloon dilatation offers a bowel-sparing treatment option, but long-term outcome and its association with patient-, stricture-, and procedure-related factors is only poorly understood. Patient satisfaction with endoscopic balloon dilatation is largely unknown. METHODS: We performed a retrospective review of all endoscopic balloon dilatation for Crohn's disease-related strictures between January 2005 and January 2013...
December 2016: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28408996/risk-factors-for-complications-after-ileocolonic-resection-for-crohn-s-disease-with-a-major-focus-on-the-impact-of-preoperative-immunosuppressive-and-biologic-therapy-a-retrospective-international-multicentre-study
#9
Takayuki Yamamoto, Antonino Spinelli, Yasuo Suzuki, Rogerio Saad-Hossne, Fabio Vieira Teixeira, Idblan Carvalho de Albuquerque, Rodolff Nunes da Silva, Ivan Folchini de Barcelos, Ken Takeuchi, Akihiro Yamada, Takahiro Shimoyama, Lorete Maria da Silva Kotze, Matteo Sacchi, Silvio Danese, Paulo Gustavo Kotze
BACKGROUND: Author note: TY, AS, YS, FVT and PGK designed the study. All authors did data collection and gave scientific contribution to the study design and discussion. TY, AS and PGK drafted the article. All authors read and approved the final version of the manuscript.In the era of biologic agents, risk factors for complications following resection for Crohn's disease have not been fully identified. In particular, the association of preoperative use of immunosuppressive and biologic agents with the incidence of complications after resection remains to be elucidated...
December 2016: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28406493/genetic-characterization-and-influence-on-inflammatory-bowel-disease-expression-in-a-diverse-hispanic-south-florida-cohort
#10
Oriana M Damas, Lissette Gomez, Maria A Quintero, Evadnie Rampersaud, Susan Slifer, Gary W Beecham, David H Kerman, Amar R Deshpande, Daniel A Sussman, Maria T Abreu, Jacob L McCauley
OBJECTIVES: Hispanics represent an understudied inflammatory bowel disease (IBD) population. Prior studies examining genetic predisposition to IBD in Hispanics are limited. In this study, we examined whether European-derived IBD variants confer risk in Hispanics and their influence on IBD phenotype in Hispanics compared to non-Hispanic whites (NHW). METHODS: Self-identified Hispanics and NHWs with IBD were included. Hispanic controls were included for our genetic analyses...
April 13, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28405717/-differential-indications-for-ileoanal-pouch-anastomosis-ulcerative-colitis-familial-adenomatous-polyposis-synchronous-colorectal-cancer-crohn-s-disease-constipation
#11
A Fürst
Ileoanal pouch anastomosis is the procedure of choice for patients with drug refractory ulcerative colitis, indeterminate colitis and familial adenomatous polyposis (FAP). In selected patient groups this procedure is a treatment option for patients with Crohn's disease, hereditary nonpolyposis colorectal cancer (HNPCC), synchronous colorectal cancer and for severe colorectal constipation refractory to conservative drug treatment. The pouch procedure provides the opportunity to avoid a permanent ileostomy. The majority of surgeons prefer the ileal J‑pouch as the construction is the easiest to perform and complications and dysfunction rates are low...
April 12, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28402994/intestinal-fibrosis-ready-to-be-reversed
#12
Giovanni Latella, Florian Rieder
PURPOSE OF REVIEW: Intestinal fibrosis is a common complication of several enteropathies, with inflammatory bowel disease (IBD) being the major cause. Intestinal fibrosis affects both ulcerative colitis and Crohn's disease, and no specific antifibrotic therapy exists. This review highlights recent developments in this area. RECENT FINDINGS: The pathophysiology of intestinal stricture formation includes inflammation-dependent and inflammation-independent mechanisms...
April 11, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28401051/surgery-in-pediatric-crohn-s-disease-indications-timing-and-post-operative-management
#13
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/28400196/association-of-rnaset2-gene-polymorphisms-with-decreased-expression-and-clinical-characteristics-of-severity-in-crohn-s-disease
#14
Rivkah Gonsky, Phillip Fleshner, Richard L Deem, Eva Biener-Ramanujan, Dalin Li, Alka A Potdar, Janine Bilsborough, Shaohong Yang, Dermot P B McGovern, Stephan R Targan
BACKGROUND & AIMS: Variants in the tumor necrosis factor superfamily member 15 gene (TNFSF15, also called TL1A) have been associated with risk for inflammatory bowel diseases (IBD). TL1A affects expression of multiple cytokines to promote mucosal inflammation. Little is known about the TL1A-response pathways that regulate cytokine expression. We investigated T-cell gene expression patterns to determine the mechanisms by which TL1A regulates cytokine production, and whether these associate with outcomes of patients with Crohn's disease (CD)...
April 8, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28395390/surgical-treatment-of-rectovaginal-fistula-in-crohn-s-disease-a-tertiary-center-experience
#15
Giovanni Milito, Giorgio Lisi, Dario Venditti, Michela Campanelli, Elena Aronadio, Michele Grande
BACKGROUND: Rectovaginal fistula (RVF) is a disastrous complication of Crohn's disease (CD) that is exceedingly difficult to treat. It is a disabling condition that negatively impacts a woman's quality of life. Current treatment algorithms range from observation to medical management to the need for surgical intervention. A wide variety of success rates have been reported for all management options. The choice of surgical repair methods depends on various fistula and patient characteristics, and its published success rates vary with initial success being around 50% rising to 80% with repeated surgery...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28387832/mesenchymal-stem-cell-injections-for-the-treatment-of-perianal-crohn-s-disease-what-we-ve-accomplished-and-what-we-still-need-to-do
#16
Amy L Lightner, William A Faubion
Perianal Crohn's disease (CD) is found in a quarter of patients with CD and remains notoriously difficult to treat. Several medical and surgical therapies are available. However, none are particularly effective or reliably provide sustained remission. In addition, surgical intervention is complicated by poor healing and the potential for incontinence. Mesenchymal stem cell based therapies provide a promising treatment alternative for perianal CD with demonstrated safety, improved efficacy, and a decreased side effect profile...
April 6, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28387079/-how-i-explore-%C3%A2-crohn-s-disease-by-various-imaging-modalities
#17
C Desir, C Coimbra, M Decker, C Reenaers, C Van Kemseke, P Latour, E Louis, P Meunier
Crohn's disease is a chronic inflammatory condition characterized by recurrent and/or chronic lesions, leading to cumulative structural bowel damage. It is established that the correlation between symptoms and intestinal lesions is weak. Therefore, monitoring by frequent cross-sectional imaging is proposed to assess the disease activity. There is no consensus about the preferred imaging option. Priority is given to non-radiating modalities, such as ultrasonography and MRI. Tomodensitometry will be reserved for emergency cases...
January 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28387059/pouch-excision-indications-and-outcomes
#18
Amy L Lightner, Sheev Dattani, Eric J Dozois, Sara B Moncrief, John H Pemberton, Kellie L Mathis
INTRODUCTION: Resotrative proctolectomy (RPC) with Ileal-pouch anal anastomosis (IPAA) is the procedure of choice for ulcerative colitis. Unfortunately, up to 10% of pouches will fail, requiring either reconstruction or excision. While several series have reported on the aetiology of pouch failure, no study to date has focused on the postoperative complications associated with pouch excision. METHODS: Patients who had excision of ileoanal reservoir with ileostomy (CPT code 45136) were included...
April 7, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28384331/a-rolling-phenotype-in-crohn-s-disease
#19
James Irwin, Emma Ferguson, Lisa A Simms, Katherine Hanigan, Franck Carbonnel, Graham Radford-Smith
BACKGROUND AND AIM: The Montreal classification of disease behaviour in Crohn's disease describes progression of disease towards a stricturing and penetrating phenotype. In the present paper, we propose an alternative representation of the long-term course of Crohn's disease complications, the rolling phenotype. As is commonly observed in clinical practice, this definition allows progression to a more severe phenotype (stricturing, penetrating) but also, regression to a less severe behaviour (inflammatory, or remission) over time...
2017: PloS One
https://www.readbyqxmd.com/read/28383450/long-term-outcomes-after-continent-ileostomy-creation-in-patients-with-crohn-s-disease
#20
Erman Aytac, David W Dietz, Jean Ashburn, Feza H Remzi
BACKGROUND: Patients with Crohn's disease have a higher failure rate after ileal pouch surgery compared with their counterparts with ulcerative colitis. OBJECTIVE: We hypothesized that risk of continent ileostomy failure can be stratified based on the timing of Crohn's disease diagnosis and aimed to assess long-term outcomes. DESIGN: This was a retrospective cohort study. SETTINGS: The investigation took place in a high-volume, specialized colorectal surgery department...
May 2017: Diseases of the Colon and Rectum
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