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Complications of Crohn's Disease

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https://www.readbyqxmd.com/read/29442063/bowel-perforation-in-crohn-s-disease-correlation-between-cdai-and-clavien-dindo-scores
#1
T Fontana, N Falco, M Torchia, R Tutino, G Gulotta
BACKGROUND: Many studies have elaborated different kind of activity indices for Crohn's Disesase (CD) with the endpoint of univocally measure and evaluate the gravity of its lesions and symptoms. AIM: Purpose of this work is to study and define the correlation that runs between the preoperative score obtained at the Crohn's Disease Activity Index, the occurrence of postoperative complications that will require re-intervention and the severity of the postoperative lesions evaluated using the Clavien-Dindo score...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29435759/prognostic-value-of-preoperative-neutrophil-to-lymphocyte-ratio-in-crohn-s-disease
#2
Stanislaus Argeny, Anton Stift, Michael Bergmann, Martina Mittlböck, Svenja Maschke, Yushan Yang, Praminthra Chitsabesan, Stefan Riss
BACKGROUND: The Neutrophil-to-lymphocyte-ratio has recently gained increased attention as a prognostic marker for malignant disease and short term outcomes. There is little data available in patients with Crohn's disease, thus the present study was conducted to correlate preoperative Neutrophil-to-lymphocyte-ratio values with disease phenotype and postoperative course. METHODS: We comprised 373 patients, who underwent intestinal resection for symptomatic Crohn's disease at an academic tertiary referral centre between 2000 and 2014...
February 12, 2018: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/29431516/does-a-histologically-inflamed-resection-margin-increase-postoperative-complications-in-patients-with-crohn-s-disease
#3
Gisele Aaltonen, Ari Ristimäki, Ilona Keränen, Monika Carpelan-Holmström, Anna Lepistö
OBJECTIVES: Our study assessed whether the presence of histologically inflamed resection margins increased postoperative anastomotic complications in Crohn's disease (CD) patients. We also examined the influence of other risk factors for postoperative complications. MATERIALS AND METHODS: Presence of chronic inflammation and activity of inflammation was scored from the resection margin specimens of 70 patients undergoing surgery due to CD. Anastomotic complications were recorded with a one-month follow-up...
February 12, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29429045/evidence-based-clinical-practice-guidelines-for-inflammatory-bowel-disease
#4
REVIEW
Katsuyoshi Matsuoka, Taku Kobayashi, Fumiaki Ueno, Toshiyuki Matsui, Fumihito Hirai, Nagamu Inoue, Jun Kato, Kenji Kobayashi, Kiyonori Kobayashi, Kazutaka Koganei, Reiko Kunisaki, Satoshi Motoya, Masakazu Nagahori, Hiroshi Nakase, Fumio Omata, Masayuki Saruta, Toshiaki Watanabe, Toshiaki Tanaka, Takanori Kanai, Yoshinori Noguchi, Ken-Ichi Takahashi, Kenji Watanabe, Toshifumi Hibi, Yasuo Suzuki, Mamoru Watanabe, Kentaro Sugano, Tooru Shimosegawa
Inflammatory bowel disease (IBD) is a chronic disorder involving mainly the intestinal tract, but possibly other gastrointestinal and extraintestinal organs. Although etiology is still uncertain, recent knowledge in pathogenesis has accumulated, and novel diagnostic and therapeutic modalities have become available for clinical use. Therefore, the previous guidelines were urged to be updated. In 2016, the Japanese Society of Gastroenterology revised the previous versions of evidence-based clinical practice guidelines for ulcerative colitis (UC) and Crohn's disease (CD) in Japanese...
February 10, 2018: Journal of Gastroenterology
https://www.readbyqxmd.com/read/29427364/crohn-s-disease-associated-strictures
#5
REVIEW
Webber Chan Pak Wo, Fadi Mourad, Rupert W L Leong
Crohn's disease (CD) is a chronic relapsing and remitting disease that can affect any segments of the gastrointestinal (GI) tract. More than 50% of patients with CD develop stricturing or penetrating complications within the first 10 years after diagnosis. Strictures can lead to intestinal obstruction, which is a common indication for surgery. Despite significant advances in the understanding of the pathogenesis of intestinal fibrostenosis, imaging and therapeutic armamentarium of CD, the risk of intestinal surgery remained significantly high...
February 10, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29423918/percutaneous-endoscopic-gastrostomy-placement-in-paediatric-crohn-s-disease-patients-contributes-to-both-improved-nutrition-and-growth
#6
H Duncan, A Painesi, E Buchanan, P McGrogan, K Gerasimidis, G Walker, G Haddock, R K Russell
AIM: This paper describes the outcomes of gastrostomy feeding in patients with Crohn's disease (CD). METHODS: Patients with CD who attended the Royal Hospital for Children, Glasgow, and received gastrostomy feeding for at least two years between 2003-2010, were identified from the clinical database. The data recorded included the anthropometric data, CD phenotype, the surgical technique that was used, complications, medication, feed type, median feed, calories, volume and clinical outcomes...
February 9, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29423160/stricturoplasty-a-bowel-sparing-option-for-long-segment-small-bowel-crohn-s-disease
#7
Alexandra M Limmer, Hoey C Koh, Andrew Gilmore
Stricturoplasty is a surgical option for management of severe stricturing Crohn's disease of the small bowel. It avoids the need for small bowel resection and the associated metabolic complications. This report contrasts the indications and technical aspects of two different stricturoplasty techniques. Case 1 describes an extensive Michelassi (side-to-side isoperistaltic) stricturoplasty performed for a 100 cm segment of diseased small bowel in a 45-year-old patient. Case 2 describes the performance of 12 Heineke-Mikulicz stricturoplasties in a 23-year-old patient with multiple short fibrotic strictures...
August 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29422799/comparison-of-time-until-elective-intestinal-resection-regarding-previous-anti-tumor-necrosis-factor-exposure-a-brazilian-study-on-patients-with-crohn-s-disease
#8
Paulo Gustavo Kotze, Daniela Oliveira Magro, Barbara Saab, Mansur Paulo Saab, Lilian Vital Pinheiro, Marcia Olandoski, Maria de Lourdes Setsuko Ayrizono, Carlos Augusto Real Martinez, Claudio Saddy Rodrigues Coy
Background/Aims: The use of anti-tumor necrosis factor (anti-TNF) agents seems to reduce surgical rates and delay surgical procedures in prospective trials and population-based studies in the management of Crohn's disease (CD). This study aimed to identify whether preoperative anti-TNF agents influence the time from diagnosis to surgery. Methods: An observational retrospective cohort study was conducted on patients with CD submitted to intestinal resections due to complications or medical therapy failure in a period of 7 years...
January 2018: Intestinal Research
https://www.readbyqxmd.com/read/29421816/b1a-lymphocytes-cd19-cd5-deficiency-in-patients-with-crohn-s-disease-and-its-relation-with-disease-severity
#9
Rafael Gil-Borras, Carlos García-Ballesteros, Carmen Benet-Campos, Ignacio Catalán-Serra, Francisca López-Chuliá, Carmen Cuéllar, Juan Carlos Andreu-Ballester
BACKGROUND/AIMS: B1a cells (CD19+CD5+) are considered elements of the innate immune system. The aim of this study was to evaluate the frequency of B1a cells in the peripheral blood of patients with Crohn's disease (CD) and its relation with disease severity. METHODS: In this prospective study, a total of 128 subjects (64 CD patients and 64 healthy controls) were studied. B1a cells in peripheral blood, CD Activity Index, and Simple Endoscopic Score of B1a cells were studied...
February 8, 2018: Digestive Diseases
https://www.readbyqxmd.com/read/29415186/microbial-spectrum-of-intra-abdominal-abscesses-in-perforating-crohn-s-disease-results-from-a-prospective-german-registry
#10
P A Reuken, W Kruis, C Maaser, N Teich, J Büning, J C Preiß, R Schmelz, T Bruns, S Fichtner-Feigl, A Stallmach
Background: Intra-abdominal abscesses (IAA) are common life threatening complications in patients with Crohn's disease (CD). In addition to interventional drainage and surgical therapy, empirical antibiotic therapy represents a corner stone of treatment but contemporary data on microbial spectra and antimicrobial resistance are scarce. Methods: We recruited 105 patients with CD and IAA from 9 German centers for a prospective registry in order to characterize the microbiological spectrum, resistance profiles, antibiotic therapy and outcome...
February 5, 2018: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29411405/fibrosis-in-ulcerative-colitis-is-directly-linked-to-severity-and-chronicity-of-mucosal-inflammation
#11
I O Gordon, N Agrawal, E Willis, J R Goldblum, R Lopez, D Allende, X Liu, D Y Patil, L Yerian, F El-Khider, C Fiocchi, F Rieder
BACKGROUND: Fibrosis in ulcerative colitis has remained largely unexplored despite its clinical implications. AIMS: This cross-sectional study was aimed at characterising the presence, anatomical location and degree of ulcerative colitis-associated fibrosis and its possible link to clinical parameters. METHODS: Seven hundred and six individual tissue cross-sections derived every 10 cm along the length of 89 consecutive Ulcerative colitis colectomy specimens were examined and compared to Crohn's disease colitis, diverticular disease and uninvolved areas from colorectal cancer patients...
February 6, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29408835/incidence-and-factors-correlating-with-incisional-hernia-following-open-bowel-resection-in-patients-with-inflammatory-bowel-disease-a-review-of-1000-patients
#12
Tomas M Heimann, Santosh Swaminathan, Adrian J Greenstein, Randolph M Steinhagen
OBJECTIVE: The aim of this study was to identify the incidence and factors associated with the development of incisional hernia (IH) in patients with inflammatory bowel disease (IBD) undergoing open bowel resections. BACKGROUND: Predisposing factors for IH have not been well studied in patients with IBD undergoing open bowel resection. The role of duration of the disease, nutritional factors, anti-inflammatory treatment, previous operative procedures, wound infection, and other complicating factors remains unclear...
March 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29406811/vedolizumab-for-the-treatment-of-crohn-s-disease
#13
Marjorie Argollo, Gionata Fiorino, Laurent Peyrin-Biroulet, Silvio Danese
Crohn's disease (CD) is an immune-mediated condition characterized by inflammation of the gut tissue, associated with progressive damage of the affected intestinal tract and possible complications. A treat-to-target approach is strongly advocated, consisting of early and aggressive inflammatory control. However, a great proportion of affected subjects lack response or are intolerant to conventional therapy. Even though the first-line biologic therapy targeting tumor necrosis factor-alfa (TNF-α) is associated with improvement of inflammation in some patients, others do not respond at first or lose response over time...
February 6, 2018: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/29406296/abdominal-catastrophe-in-crohn-s-disease-surgery
#14
Hugo Palma Rios, André Goulart, Pedro Leão
INTRODUCTION: Performing surgery on patients with Crohn's disease is a true challenge due to the elevated risk of complications related to the chronic proinflammatory response. Stenosis is the leading cause of intestinal resection in these patients. CASE REPORT: The authors present the case of a 50-year-old woman with inflammatory stenosis of the terminal ileum due to Crohn's disease. The patient underwent a laparoscopic ileocecal resection, which was complicated by a small anastomotic dehiscence with localized peritonitis...
January 2018: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29400377/the-added-value-of-contemporary-ultrasound-technologies-in-the-diagnosis-of-malignant-tumours-of-the-gastrointestinal-system-a-case-report
#15
Johannes Rübenthaler, Maximilian Reiser, Dirk-André Clevert
Ultrasound of the gastrointestinal system has become more popular among clinicians and is an important tool for evaluation and follow-up. Ultrasound has a special value in patients with Crohn's disease for the evaluation of disease activity but also for the evaluation of abdominal complications and shows comparable results to other imaging modalities. With the introduction of elastography and contrast-enhanced ultrasound into clinical routine, THE sonographic evaluation of the small bowel is even more sophisticated and even more precise...
February 4, 2018: Medical Ultrasonography
https://www.readbyqxmd.com/read/29374636/clostridium-difficile-enteritis-diffuse-small-bowel-radiological-changes-in-a-patient-with-abdominal-sepsis
#16
Juveria Siddiqui, Thomas Campion, Rui Wei, Siarhei Kuzmich
While imaging appearances of pseudomembranous colitis are commonly recognised, radiological manifestations of Clostridium difficile-associated enteritis are poorly understood which, combined with the rarity of this infection involving small bowel, makes establishing the correct diagnosis challenging. Therefore, in order to encourage awareness of readers, we present a case of C. difficile enteritis that manifested as abdominal sepsis complicating the postoperative period in a middle-aged woman with fistulating Crohn's disease and defunctioning ileostomy...
January 26, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29374617/efficacy-of-medical-therapies-for-fistulizing-crohn-s-disease-systematic-review-and-meta-analysis
#17
REVIEW
Matthew J Lee, Claire E Parker, Sarah R Taylor, Leonardo Guizzetti, Brian G Feagan, Alan J Lobo, Vipul Jairath
BACKGROUND & AIMS: Fistulas are debilitating complications of Crohn's disease (CD) that affect up to 50% of patients. We conducted a systematic review and meta-analysis of randomized controlled trials to assess the efficacy of treatments for fistulizing CD. METHODS: We searched publication databases from inception through December 13, 2016 for trials comparing the efficacy of a therapeutic agent (single or combination) with placebo or another active therapy in adult patients with any form of fistulizing CD...
January 25, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29370898/postoperative-complications-of-pediatric-patients-with-inflammatory-bowel-disease-treated-with-vedolizumab
#18
Lori A Zimmerman, Jill M Zalieckas, Robert C Shamberger, Athos Bousvaros
BACKGROUND: Vedolizumab is a biologic, which inhibits leukocyte adhesion in the gut and is used to treat ulcerative colitis (UC) and Crohn's disease (CD). Little is known of the surgical outcomes in patients treated with vedolizumab. We reviewed the postoperative complications in a cohort of pediatric UC and CD patients treated with vedolizumab. METHODS: We identified pediatric UC and CD patients treated with vedolizumab at our institution from 2014 to 2016. We compared postoperative outcomes in the vedolizumab exposed group to a cohort of vedolizumab naïve patients who required diverting ileostomy...
December 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29364456/pellagra-affecting-a-patient-with-crohn-s-disease
#19
Shi Hui, Lu Heng, Wang Shaodong, Wang Fangyu, Wang Zhenkai
Pellagra is a nutritional disease caused by a deficiency of niacin. It may lead to death if not identified and treated timely. We review the literature and report a female patient presented with clinical features of pellagra as a complication of Crohn's disease.
November 2017: Anais Brasileiros de Dermatologia
https://www.readbyqxmd.com/read/29361163/genomic-and-expression-analyses-identify-a-disease-modifying-variant-for-fibrostenotic-crohn-s-disease
#20
Marijn C Visschedijk, Lieke M Spekhorst, Shih-Chin Cheng, Ellen S van Loo, B H Dianne Jansen, Tjasso Blokzijl, Hyunsuk Kil, Dirk J de Jong, Marieke Pierik, Jeroen P W J Maljaars, C Janneke van der Woude, Adriaan A van Bodegraven, Bas Oldenburg, Mark Löwenberg, Vincent B Nieuwenhuijs, Floris Imhann, Suzanne van Sommeren, Rudi Alberts, Ramnik J Xavier, Gerard Dijkstra, Klaas Nico Faber, C Marcelo Aldaz, Rinse K Weersma, Eleonora A M Festen
Background and Aims: Crohn's Disease (CD) is a chronic inflammatory disease with unpredictable behaviour. More than half of CD patients eventually develop complications such as stenosis, for which they then require endoscopic dilatation or surgery, as no anti-fibrotic drugs are currently available. We aim to identify disease-modifying genes associated with fibrostenotic CD. Methods: We performed a within-case analysis comparing "extreme phenotypes" using the Immunochip and replication of the top SNPs with Agena Bioscience in two independent case-control cohorts totalling 322 cases with fibrostenotis (recurrent after surgery) and 619 cases with purely inflammatory CD...
January 19, 2018: Journal of Crohn's & Colitis
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