Surgical strategy in massive colorectal bleeding

Several pathologic disorders can become a sou-rce of severe gastrointestinal bleeding. The most frequently observed entities responsible for massi-ve colorectal bleeding are diverticulae, intestinal angiodysplasias, inflammatory bowel diseases and cancers. In order to choose the best - surgical - method to stop the hemorrhage and cure the disease; it is mandatory to properly identify the origin and location of the bleeding. It is a common experience that the usually advised diagnostic methods often yield disappointing results in urgent cases. The presented case shows that selective angiography can lead to the fastest diagnosis in angiodysplasia and with surgery a definitive result can be obtained.

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The pathomorphosis of inflammatory bowel diseases

Annals of the Russian academy of medical sciences ◽

10.15690/vramn1219 ◽

2020 ◽

Vol 75 (1) ◽

pp. 27-35

Author(s):

Igor V. Maev ◽

Yurii A. Shelygin ◽

Maria I. Skalinskaya ◽

Alexey V. Veselov ◽

Ekaterina V. Skazyvaeva ◽

...

Keyword(s):

Inflammatory Bowel Diseases ◽

Clinical Symptoms ◽

Term Treatment ◽

Diagnostic Methods ◽

Induction Treatment ◽

Differential Analysis ◽

Number Of Patients ◽

Long Term Treatment ◽

Bowel Diseases ◽

Inflammatory Bowel

Inflammatory bowel diseases (IBD) are immune-mediated diseases and usually manifest at a young age. They are requires in a long-term treatment or surgery with a high probability of surgical intervention. IBDs are accompanied by a decrease in working capacity, impaired quality of life and social disadaptation. However, timely diagnosis with using modern diagnostic methods, the use of evidence-based immunosuppressive and biological therapy significantly changed the pathomorphosis of this disease. But despite the achievements of the pharmacotherapy, the incidence and prevalence of IBD are still increasing, a demand for surgery remains both for Crohn`s disease and ulcerative colitis throughout all the period of illness. At the same time there is a trend towards the variability of symptoms, mismatch of the clinical symptoms with the real severity of inflammation, increase of a number of patients with extraintestinal manifestations and resistance to induction and maintenance therapies. In addition to this, the observation of this group of patients is complicated due to the difficulty of the early diagnosis and differential analysis of IBD, the need of early induction treatment according to the guidelines and the lack of adherence to the therapy.

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INFLAMMATORY BOWEL DISEASES AND FOOD ALLERGY: PATHOGENETIC AND CLINICAL PARALLELS

PEDIATRIA Journal named after G N SPERANSKY ◽

10.24110/0031-403x-2021-100-1-112-119 ◽

2021 ◽

Vol 100 (1) ◽

pp. 112-119

Author(s):

S.G. Makarova ◽

◽

I.G. Gordeeva ◽

A.N. Surkov ◽

◽

...

Keyword(s):

Food Allergy ◽

Intestinal Microbiota ◽

Inflammatory Bowel Diseases ◽

Transforming Growth Factor ◽

Clinical Manifestations ◽

Allergic Diseases ◽

Diagnostic Methods ◽

Bowel Diseases ◽

Inflammatory Bowel ◽

Endoscopic Picture

Inflammatory bowel diseases (IBD), like allergic diseases, are referred to «diseases of civilization», and their prevalence is growing throughout the world, including in the pediatric population. Both diseases refer to immunopathological conditions and have not only some common pathogenesis, but also similar clinical picture. It is also known about common factors that contribute to the predisposition to both groups of diseases – both genetic and environmental – vitamin D deficiency, changes in the intestinal microbiota composition etc. However, the mechanisms of observed relationship between IBD and food allergy (FA) are not fully understood. In this review, devoted to the current state of the problem, the pathogenetic and clinical parallels between FA and IBD are considered in detail. FA gastrointestinal symptoms may not differ from IBD onset, and the endoscopic picture may mimic the symptoms seen in patients with IBD. Indeed, the verification of gastrointestinal FA is still difficult due to the lack of reliable laboratory diagnostic methods. Besides misdiagnosis, comorbidity between FA and IBD is described. The complex pathogenetic mechanism of both IBD and allergic reactions is based on eosinophils, helper Th2 and Th17 cells, and transforming growth factor β. The common pathogenetic mechanisms lead to similar clinical manifestations, when not only the digestive system, but also the respiratory system and skin can be affected, although this is much less common in IBD. An important role is played by intestinal barrier state and intestinal microbiota – it was revealed that in children with certain genotypes, intestinal dysbiosis can cause immune abnormalities, leading to both allergic diseases and IBD.

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