Is it possible to prevent recurrent Crohn's disease with medical or surgical interventions?

1996 ◽  
Vol 48 (2) ◽  
pp. 68-70 ◽  
Author(s):  
R MCLEOD
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Surgical Interventions

Su2069 ELECTIVE VS UNPLANNED SURGICAL INTERVENTIONS FOR BOWEL OBSTRUCTION IN CROHN'S DISEASE: IS THERE A ROLE FOR PREEMPTIVE SURGICAL INTERVENTION?

2020 ◽  
Vol 158 (6) ◽  
pp. S-1570
Author(s):  
David Koller ◽  
Kenneth D. Allen ◽  
Sean Maroney ◽  
Alan Harzman ◽  
mark arnold ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Surgical Interventions

scholarly journals British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults

Gut ◽  
2019 ◽  
Vol 68 (Suppl 3) ◽  
pp. s1-s106 ◽  
Author(s):  
Christopher Andrew Lamb ◽  
Nicholas A Kennedy ◽  
Tim Raine ◽  
Philip Anthony Hendy ◽  
Philip J Smith ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
British Society ◽  
Delphi Consensus ◽  
Surgical Interventions ◽  
Abdominal Radiology ◽  
Inflammatory Bowel

Ulcerative colitis and Crohn’s disease are the principal forms of inflammatory bowel disease. Both represent chronic inflammation of the gastrointestinal tract, which displays heterogeneity in inflammatory and symptomatic burden between patients and within individuals over time. Optimal management relies on understanding and tailoring evidence-based interventions by clinicians in partnership with patients. This guideline for management of inflammatory bowel disease in adults over 16 years of age was developed by Stakeholders representing UK physicians (British Society of Gastroenterology), surgeons (Association of Coloproctology of Great Britain and Ireland), specialist nurses (Royal College of Nursing), paediatricians (British Society of Paediatric Gastroenterology, Hepatology and Nutrition), dietitians (British Dietetic Association), radiologists (British Society of Gastrointestinal and Abdominal Radiology), general practitioners (Primary Care Society for Gastroenterology) and patients (Crohn’s and Colitis UK). A systematic review of 88 247 publications and a Delphi consensus process involving 81 multidisciplinary clinicians and patients was undertaken to develop 168 evidence- and expert opinion-based recommendations for pharmacological, non-pharmacological and surgical interventions, as well as optimal service delivery in the management of both ulcerative colitis and Crohn’s disease. Comprehensive up-to-date guidance is provided regarding indications for, initiation and monitoring of immunosuppressive therapies, nutrition interventions, pre-, peri- and postoperative management, as well as structure and function of the multidisciplinary team and integration between primary and secondary care. Twenty research priorities to inform future clinical management are presented, alongside objective measurement of priority importance, determined by 2379 electronic survey responses from individuals living with ulcerative colitis and Crohn’s disease, including patients, their families and friends.

Intestinal Failure and Short Bowel Syndrome in Crohn’s Disease: A Systematic Review

2021 ◽  
pp. 77-86
Author(s):  
Hayslan Theobaldo Boemer ◽  
Ana Valéria Garcia Ramirez ◽  
Durval Ribas Filho
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Short Bowel Syndrome ◽  
Intestinal Failure ◽  
Intestinal Secretion ◽  
Surgical Interventions ◽  
Short Bowel ◽  
Intestinal Length ◽  
Intestinal Rehabilitation ◽  
Long Term Prognosis

Crohn's disease (CD) is an inflammatory, chronic and progressive disease that affects the digestive tract. Despite optimized drug therapy, the risk of multiple surgical interventions over the years is high, leading the patient to develop short bowel syndrome (SBS). Thus, adequate management in the postoperative period directly interferes with the long-term prognosis. Initially, most of these patients, due to hydro electrolytic disorders and absorptive incapacity inherent in SBS, will need parenteral nutritional support. According to the patient's residual digestive profile and according to nutritional management (oral, enteral, and/or parenteral), the intestine will evolve in its adaptive capacity. During this period, control agents are used for motility and intestinal secretion and, if necessary, GLP-2 agonists (intestinotrophic). In cases refractory to these treatments, we can still indicate surgical procedures to control motility, increasing intestinal length, and, finally, transplantation. CD is recurrent, and patients with SBS need a multidisciplinary approach with continuous monitoring to provide better intestinal rehabilitation and consequent quality of life.

Cutaneous penile and perianal Crohn's disease treated with a combination of medical and surgical interventions

2008 ◽  
Vol 49 (1) ◽  
pp. 21-24 ◽  
Author(s):  
Sanjay M Rajpara ◽  
Sanjay K Siddha ◽  
Anthony D Ormerod ◽  
Keith M Kerr ◽  
Prahalad S Kolhe
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Surgical Interventions ◽  
Perianal Crohn’S Disease ◽  
Perianal Crohn's Disease

scholarly journals Surgical treatment of complications of Crohn’s disease

2018 ◽  
Vol 20 (1) ◽  
pp. 111-116
Author(s):  
I A Solovev ◽  
A M Pershko ◽  
D P Kurilo ◽  
M V Vasilchenko ◽  
E S Silchenko ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Surgical Treatment ◽  
Crohn's Disease ◽  
Surgical Intervention ◽  
Intestinal Anastomosis ◽  
Clinical Manifestations ◽  
Intestinal Fistula ◽  
Subtotal Resection ◽  
Surgical Interventions ◽  
Conservative And Surgical Treatment

Possibilities and options of surgical treatment of complications of Crohn’s disease in the general surgical hospital are considered. Patients underwent various surgical interventions: ileum resection with «side-to-side» anastomosis (4 patients), resection of ileocecal department with the formation of ileoascendoanastomosis (2 patients), total coloproctectomy with the formation of ileostomy (2 patients), right-sided hemicolectomy (1 patient), obstructive resection of transverse colon (1 patient), obstructive resection of sigmoid colon (2 patients). Postoperative complications developed in 3 patients (25%), among them: postoperative wound suppuration - 2, dehiscence of anastomosis in 1 patient, which led to the formation of internal intestinal fistula and death. It was found that with limited lesions of colon in Crohn’s disease (less than a third of the colon) can be limited to resection of the affected segment with formation of intestinal anastomosis in the limits of healthy tissues. In the presence of lesions in the ascending department of colon proximal border of resection should be at the level of middle colic vessels with preservation of the latter. In long Crohn’s disease of colon with severe clinical manifestations of the operation of choice is a subtotal resection of colon with the imposition of single-barrel ileostomy. Surgical treatment of complicated forms of Crohn’s disease is in all cases performed in surgical profile hospitals, taking patients by ambulance. Most often, patients have delayed indications for operations, which gives the opportunity to carry out a comprehensive preoperative preparation. In all cases, complications of Crohn’s disease requires an individual approach, which combines conservative and surgical treatment. Surgical intervention is determined by the shape and characteristics of the course of complications of Crohn’s disease.

scholarly journals Features of the manifestation and course of Crohn’s disease in three brothers

2021 ◽  
Vol 11 (3) ◽  
pp. 70-77
Author(s):  
A. V. Morkovina ◽  
E. Yu. Yuryeva ◽  
T. L. Lapina ◽  
P. V. Pavlov ◽  
A. S. Tertychnyy ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Case Reports ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Diffuse Peritonitis ◽  
Surgical Interventions ◽  
Gradual Onset ◽  
Familial Form ◽  
Disease Location

Hereditary predisposition is the most significant risk factor for Crohn’s disease (CD) in siblings. Case reports. CD was diagnosed in 3 brothers in a family with 6 children of the same generation: the disease manifested itself in one — at the age of 15 years and in two brothers — at the age of 17 years. In the older brother, CD manifested with acute intestinal obstruction, ileum perforation, diffuse peritonitis; in the middle — with symptoms similar to appendicular infiltrate. Both brothers underwent resection of the terminal ileum, cecum, and part of the ascending colon with the imposition of ileoascendoanastomosis. The younger brother was diagnosed with a non-stricturing, non-penetrating form of CD with a gradual onset and no complications. Among the siblings without CD, two have rheumatoid arthritis and vitiligo. Discussion. Similar signs of the familial form of CD were young age of manifestation and ileocolonic disease location; distinctive signs — the presence of complications and surgical interventions in only two brothers. A special feature of the case reports is the CD development only in boys and the combination of three different autoimmune diseases in one generation of the family.

scholarly journals Is There a Role for Ileal Pouch Anal Anastomosis in Crohn's Disease?

2019 ◽  
Vol 32 (04) ◽  
pp. 280-290
Author(s):  
Nicole E. Lopez ◽  
Karen Zaghyian ◽  
Phillip Fleshner
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Ileal Pouch ◽  
Ileorectal Anastomosis ◽  
Total Proctocolectomy ◽  
Biologic Therapies ◽  
Total Abdominal Colectomy ◽  
Surgical Interventions ◽  
Rectal Involvement ◽  
Intestinal Continuity

AbstractTraditionally, surgical interventions for colonic Crohn's disease (CD) have been limited to total abdominal colectomy and ileorectal anastomosis, or total proctocolectomy with end ileostomy if there is rectal involvement. However, improved understandings of the biology of CD, as well as the development of biologic therapies, have enabled more limited resections. Here, we review the indications for, and limitations of, specific procedures aiming to preserve intestinal continuity in colonic CD.

scholarly journals Minor Sphincter Sparing Surgery for Successful Closure of Perianal Fistulas in Patients with Crohn’s Disease

2021 ◽  
Vol 10 (20) ◽  
pp. 4721
Author(s):  
Jennifer Merten ◽  
Ann-Kathrin Eichelmann ◽  
Rudolf Mennigen ◽  
Isabelle Flammang ◽  
Andreas Pascher ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Surgical Procedures ◽  
Surgical Techniques ◽  
Advancement Flap ◽  
University Hospital ◽  
High Rate ◽  
Surgical Interventions ◽  
Perianal Fistulas ◽  
Fistula Plug

The purpose of this study is to demonstrate that repetitive minor surgical procedures allow for a high rate of permanent closure of perianal fistulas in patients with Crohn’s disease (CD). Patients with perianal fistulizing CD (PFCD) who underwent perianal surgery at the University Hospital of Muenster between 2003 and 2018 were assessed for fistula characteristics and surgical procedures. We included 45 patients (m:f = 28:17) with a mean age of 27 years at first fistula appearance. Of these, 49% suffered from a complex fistula. An average of 4.2 (1–14) procedures were performed, abscess incisions and fistula-seton-drainages included. Draining setons were left in place for 5 (1–54) months, until fistula closure. Final surgical techniques were fistulotomy (31.1%), seton removal with sustained biological therapy (26.7%), Anal Fistula Plug (AFP) (17.8%), Over-The Scope-Clip proctology (OTSC) (11.1%), and mucosa advancement flap (4.4%). In 8.9% of cases, the seton was kept as permanent therapy. The time from first to last surgery was 18 (0–182) months and the median follow-up time after the last surgery was 90 (15–200) months. The recurrence rate was 15.5% after 45 (17–111) months. Recurrent fistulas healed after another 1.86 (1–2) surgical re-interventions. The final success rate was 80%. Despite biological treatment, PFCD management remains challenging. However, by repeating minor surgical interventions over a prolonged period of time, high permanent healing rates can be achieved.

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