scholarly journals A case of pneumoperitoneum after diagnostic colonoscopy for ulcerative colitis managed conservatively: a rare but possible complication

2021 ◽  
Vol 8 (3) ◽  
pp. 1023
Author(s):  
Neel B. Patel ◽  
Hitendra K. Desai ◽  
Purvesh Doshi ◽  
Bansil Javia
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Surgical Intervention ◽  
Safe Procedure ◽  
Free Air ◽  
Increased Risk ◽  
Active Colitis ◽  
Intraperitoneal Free Air ◽  
Inflammatory Bowel

Ulcerative colitis is a chronic disease characterized by recurring episodes of inflammation of the colonic mucosae. Patients with ulcerative colitis are at an increased risk of perforations due to friability of colonic mucosa. Colonoscopy is usually regarded as a safe procedure, but complications may occur. Perforations associated with colonoscopy are dreaded complications. Most patients with pneumoperitoneum require surgical intervention, with associated major postoperative morbidity and mortality. This case report describes a 30 year old female presenting with an extensive pneumoperitoneum 2 days after colonoscopy done for her complaint of melena for one week. Colonoscopy was suggestive of severe active colitis in background of chronic ulcerative colitis. Histopathological reports s/o inflammatory bowel disease ulcerative colitis likely. CT Abdomen was s/o diffuse concentric thickening of the large bowel more predominantly seen in rectosigmoid colon, ascending colon, caecum, IC junction and consistent with inflammatory bowel disease and moderate pneumoperitoneum noted. The patient remained stable despite intraperitoneal free air. Patient was managed conservatively and no surgical intervention needed.

scholarly journals The Changing Prognosis of Ulcerative Colitis and Crohn’s Disease by Decades

2021 ◽  
Author(s):  
Burton I Korelitz ◽  
Judy Schneider
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Medical Therapy ◽  
Bowel Disease ◽  
Surgical Intervention ◽  
Inflammatory Bowel

Abstract We present a bird’s eye view of the prognosis for both ulcerative colitis and Crohn’s disease as contained in the database of an Inflammatory Bowel Disease gastroenterologist covering the period from 1950 until the present utilizing the variables of medical therapy, surgical intervention, complications and deaths by decades.

scholarly journals P058 INCISIONAL HERNIA REPAIR IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Hans Lovén ◽  
Rune Erichsen ◽  
Anders Tøttrup ◽  
Thue Bisgaard
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Bowel Disease ◽  
Incisional Hernia Repair ◽  
Increased Risk ◽  
Abdominal Operations ◽  
Inflammatory Bowel

Abstract Aim Patients with inflammatory bowel disease (IBD) are likely to undergo several abdominal operations and may thus be at increased risk for incisional hernia repair (IHR). The aim of the present study was to investigate risk and predictors of IHR in patients undergoing surgery for ulcerative colitis (UC) or Crohn’s disease (CD). Material and Methods Nationwide register-based study (1996-2018). Patients were followed from date of first abdominal operation until the date of the first IHR. Cumulative incidence proportion were estimated treating death as competing risk. Cox proportional hazard regression was used to explore pre-study defined predictors of IHR. Results Patients with inflammatory bowel disease (IBD) are likely to undergo several abdominal operations and may thus be at increased risk for incisional hernia repair (IHR). The present study analyzed the risk and predictors of IHR in patients undergoing surgery for ulcerative colitis (UC) or Crohn’s disease (CD). Conclusions The risk for incisional hernia repair is relatively low after IBD-surgery, although increased in UC compared with CD patients. Hernia repair predictors varied between UC and CD patients.

scholarly journals Cerebral Venous Sinus Thrombosis in a Patient with Ulcerative Colitis Flare

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
L. M. Conners ◽  
R. Ahad ◽  
P. H. Janda ◽  
Z. Mudasir
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Sinus Thrombosis ◽  
Rare Complication ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
Increased Risk ◽  
Inflammatory Bowel

Inflammatory bowel disease is characterized by a chronic inflammatory state and is therefore associated with abnormalities in coagulation and a hypercoagulable state. Cerebral venous sinus thrombosis is a rare complication of inflammatory bowel disease yet contributes significant morbidity and mortality to those affected. Early diagnosis is critical, as a delay in diagnosis portends a worse prognosis. This paper seeks to highlight the increased risk of venous sinus thrombosis in patients with inflammatory bowel disease. We start by discussing the case of a seventeen-year-old female who presented with ulcerative colitis flare and developed new-onset seizures, found to be caused by a large venous sinus thrombosis.

Monocytosis Is a Biomarker of Severity in Inflammatory Bowel Disease: Analysis of a 6-Year Prospective Natural History Registry

2021 ◽  
Author(s):  
Alyce Anderson ◽  
Cynthia Cherfane ◽  
Benjamin Click ◽  
Claudia Ramos-Rivers ◽  
Ioannis E Koutroubakis ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Natural History ◽  
Crohn Disease ◽  
Bowel Disease ◽  
Disease Type ◽  
Care Utilization ◽  
Increased Risk ◽  
Inflammatory Bowel

Abstract Background Inflammatory bowel disease (IBD) is associated with alterations of the innate and adaptive immune systems. Monocytes respond to inflammation and infection, yet the relationship between monocytosis and IBD severity is not fully understood. We aimed to characterize the prevalence of monocytosis in IBD and the association between monocytosis and disease severity and IBD-related health care utilization. Methods We used a multiyear, prospectively collected natural history registry to compare patients with IBD with monocytosis to those without monocytosis, among all patients and by disease type. Results A total of 1290 patients with IBD (64.1% with Crohn disease; 35.9% with ulcerative colitis) were included (mean age 46.4 years; 52.6% female). Monocytosis was found in 399 (30.9%) of patients with IBD (29.3% with Crohn disease; 33.9% with ulcerative colitis). Monocytosis was significantly associated with abnormal C-reactive protein level and erythrocyte sedimentation rate, anemia, worse quality of life, active disease, and increased exposure to biologics (all P < 0.001). Compared with patients without monocytosis, patients with monocytosis had a 3-fold increase in annual financial health care charges (median: $127,013 vs. $32,925, P < 0.001) and an increased likelihood of hospitalization (adjusted odds ratio [AOR], 4.5; P < 0.001), IBD-related surgery (AOR, 1.9; P = 0.002), and emergency department (ED) use (AOR, 2.8; P < 0.001). Patients with monocytosis had a shorter time to surgery, hospitalization, and ED visit after stratifying by disease activity (all P < 0.05). Conclusions Patients with IBD with monocytosis, regardless of disease type, are at increased risk for worse clinical outcomes, hospitalization, surgery, and ED use. Peripheral monocytosis may represent a routinely available biomarker of a distinct subgroup with severe disease.

scholarly journals Cancer Risk in Inflammatory Bowel Disease

1995 ◽  
Vol 9 (1) ◽  
pp. 23-26 ◽  
Author(s):  
Anders M Ekbom
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Colonic Involvement ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
Risk Of Cancer

There is an increased risk of cancer in both ulcerative colitis and Crohn's disease. In 3121 patients with ulcerative colitis, 225 cases of cancer were diagnosed compared with 142.1 expected (standardized incidence ratio [SIR] 1.6, 95% CI 1.4 to 1.8), and in 1655 patients with Crohn's disease, 58 cases of cancer were detected compared with 47.1 expected (SIR 1.2, 95% CI 0.9 to 1.6). After excluding colorectal cancer the observed number of malignancies was very close to that expected for ulcerative colitis (SIR 1.0, 95% CI 0.9 to 1.2) and for Crohn's disease (SIR 1.1, 95% CI 0.8 to 1.5). Thus, the increased risk of cancer in inflammatory bowel disease is confined to colorectal cancer. In Crohn's disease 12 cases of colorectal cancer were observed (SIR 2.5, 95% CI 1.3 to 4.3). The increased risk was confined to those with colonic involvement and young age at diagnosis. In patients with colonic involvement and younger than age 30 years at diagnosis, the SIR was 20.9 (95% CI 6.8 to 48.7) versus 2.2 for those older than 30 years at diagnosis (95% CI 0.6 to 5.7). In ulcerative colitis 91 cases of colorectal cancer were observed with an SIR of 5.7 (95% CI 4.6 to 7.0). Extensive disease and young age at diagnosis were independent risk factors. Pancolitis at diagnosis resulted in an SIR of 14.8 (95% CI 11.4 to 18.9), 2.8 in left-sided colitis (95% CI 1.6 to 4.4) and 1.7 in proctitis (95% CI 0.8 to 3.2). There is great variation in the risk estimates in different studies worldwide. Different treatment strategies could be an explanation, a hypothesis that was substantiated in a study of 102 cases of colorectal cancer among patients with ulcerative colitis compared with 196 controls. Pharmacological therapy with sulfasalazine entailed a strong protective effect against colorectal cancer (relative risk of 0.34, 95% CI 0.190 to 0.62).

scholarly journals Ulcerative colitis has an aggressive course after orthotopic liver transplantation for primary sclerosing cholangitis

Gut ◽  
1998 ◽  
Vol 43 (5) ◽  
pp. 639-644 ◽  
Author(s):  
G V Papatheodoridis ◽  
M Hamilton ◽  
P K Mistry ◽  
B Davidson ◽  
K Rolles ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Liver Transplantation ◽  
Primary Sclerosing Cholangitis ◽  
Bowel Disease ◽  
Sclerosing Cholangitis ◽  
De Novo ◽  
Increased Risk ◽  
Inflammatory Bowel

Background—The course of inflammatory bowel disease after liver transplantation has been reported as variable with usually no change or improvement, but there may be an increased risk of early colorectal neoplasms. In many centres steroids are often withdrawn early after transplantation and this may affect inflammatory bowel disease activity.Aims—To evaluate the course of inflammatory bowel disease in primary sclerosing cholangitis transplant patients who were treated without long term steroids.Methods—Between 1989 and 1996, there were 30 patients transplanted for primary sclerosing cholangitis who survived more than 12 months. Ulcerative colitis was diagnosed in 18 (60%) patients before transplantation; two had previous colectomy. All patients underwent colonoscopy before and after transplantation and were followed for 38 (12–92) months. All received cyclosporin or tacrolimus with or without azathioprine as maintenance immunosuppression.Results—Ulcerative colitis course after transplantation compared with that up to five years before transplantation was the same in eight (50%) and worse in eight (50%) patients. It remained quiescent in eight and worsened in four of the 12 patients with pretransplant quiescent course, whereas it worsened in all four patients with pretransplant active course (p=0.08). New onset ulcerative colitis developed in three (25%) of the 12 patients without inflammatory bowel disease before transplantation. No colorectal cancer has been diagnosed to date.Conclusions—Preexisting ulcerative colitis often has an aggressive course, while de novo ulcerative colitis may develop in patients transplanted for primary sclerosing cholangitis and treated without long term steroids.

scholarly journals Lifestyle Issues in Inflammatory Bowel Disease – Smoking

1994 ◽  
Vol 8 (7) ◽  
pp. 422-427 ◽  
Author(s):  
Cecilia Benoni
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Protective Effect ◽  
Bowel Disease ◽  
Clinical Course ◽  
Clinical Effects ◽  
Increased Risk ◽  
Inflammatory Bowel

During the pa t decade, smoking habit has been identified as a major exogenous factor in inflammatory bowel disease (IBD). It is associated not only with the development of the disease but al o with the clinical course in established disease. IBD combines absolute opposites as smoking is associated with Crohn’s disease and nonsmoking or former smoking with ulcerative colitis. The first reports of a negative association between smoking and ulcerative colitis were based on independent, clinical observations; from those studies a positive association was found between smoking and Crohn’s disease. Epidemiological studies that followed consistently showed that smokers have a reduced risk of ulcerative colitis and an increased risk of Crohn’s disease and that exsmokers have an increased risk of ulcerative colitis. In ulcerative colitis, but not in Crohn’s disease, a dose-response pattern has been demonstrated. Changes in clinical course, in disease severity and extension, and in recurrence rate indicate substantial clinical effects of smoking with a protective effect of smoking in ulcerative colitis and an aggravating effect in Crohn’s disease. There are also indications of smoking’s effects on changes in IBD epidemiology and sex distribution. The biological explanation to the finding is unknown. Smoking may aggravate Crohn’s disease by vascular effects. Theories on the protective effect in ulcerative colitis include effects on immune and inflammatory response, on mucus and on intestinal permeability. Possibly, beneficial effects in ulcerative colitis are exerted by nicotine but further studies are needed. Due to overall negative effects of smoking, IBD patients should not smoke. It seems, however, reasonable to give individual advice in patients with ulcerative colitis who have experienced a beneficial effect of ·making considering both current health status and life situation.

scholarly journals Risk of Inflammatory Bowel Disease in Patients with Chronic Myeloproliferative Neoplasms: A Danish Nationwide Cohort Study

Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2700
Author(s):  
Marie Bak ◽  
Tine Jess ◽  
Esben Meulengracht Flachs ◽  
Ann-Dorthe Zwisler ◽  
Knud Juel ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Cohort Study ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Myeloproliferative Neoplasms ◽  
Increased Risk ◽  
Hematological Cancers ◽  
Inflammatory Bowel

An association between hematological cancers and inflammatory bowel disease (IBD) has previously been suggested, but the risk of IBD in patients with myeloproliferative neoplasms (MPNs) is unknown. We conducted a nationwide population-based cohort study using Danish registries, to estimate the risk of IBD in individuals diagnosed with essential thrombocythemia, polycythemia vera, myelofibrosis or unclassifiable MPN during 1994–2013. MPN patients were matched 1:10 with sex- and age-matched comparisons. Everyone was followed until a diagnosis of IBD, death/emigration, or 31 December 2013. The risk of IBD overall and according to MPN subtype was calculated using Cox regression and presented as hazard ratios (HRs) with 95% confidence intervals (CI). Of 8207 MPN patients followed for 45,232 person-years, 80 were diagnosed with IBD (61 ulcerative colitis, 19 Crohn’s disease). The rate of IBD per 1000 person-years was 1.8 (95% CI:1.4–2.2) in patients vs. 0.8 (95% CI:0.7–0.8) in comparisons, and the absolute 10-year risk of IBD was 0.8% (95% CI:0.6–1.0) in patients vs. 0.4% (95% CI:0.4–0.5) in comparisons. The HR of IBD was 2.4 (95% CI:2.1–2.9) with similar HRs for ulcerative colitis and Crohn’s disease. MPN subtype risks varied from 2.1 (95% CI:1.6–2.7) to 2.8 (95% CI:2.1–3.7). Our unselected cohort study showed a more than 2-fold increased risk of IBD in MPN patients.

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