scholarly journals The Occurrence of Postoperative Complications in Patients Undergoing Surgery due to Complications from Crohn's Disease: A Case Report

2018 ◽  
Vol 35 (1) ◽  
pp. 73-80
Author(s):  
Vladimir Joksimović ◽  
Nikola Jankulovski ◽  
Svetozar Antović ◽  
Marija Joksimović ◽  
Ljubinka Mančeva
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Surgical Treatment ◽  
Gastrointestinal Tract ◽  
Crohn's Disease ◽  
Resection Margins ◽  
Chronic Inflammatory Condition ◽  
Positive Resection Margins ◽  
Low Levels ◽  
Emergent Case

Summary Crohn's disease (CD) is a chronic inflammatory condition of the gastrointestinal tract that can give rise to strictures, inflammatory masses, fistulas, abscesses, hemorrhage, and cancer. This disease commonly affects the small bowel, colon, rectum or anus. Less commonly, it affects the stomach, esophagus and mouth. Often, the disease affects multiple areas of the gastrointestinal tract. The cause of CD is not known and there is no curative treatment. The current medical and surgical treatment is effective in controlling the disease, but even with optimal treatment, recurrences and relapses are frequent. Various risk factors specific for the patients with conditions related to the CD can influence the outcome of the surgical treatment in the postoperative period. Those risk factors can be preoperative laboratory inflammatory markers such as WBC and CRP values, phlegmona of the anterior abdominal wall and preoperative interintestinal abscess, positive resection margins. Here we present a case of a patient who was surgically treated as an emergent case because of the complication due to Crohn's disease. At presentation, the patient had leukocytosis, elevated CRP, anemia, low levels of total proteins, and albumin.

scholarly journals The Influence of Microscopic Inflammation at Resection Margins on Early Postoperative Endoscopic Recurrence After Ileocaecal Resection for Crohn’s Disease

2019 ◽  
Vol 14 (3) ◽  
pp. 361-368 ◽  
Author(s):  
Karolina Poredska ◽  
Lumir Kunovsky ◽  
Filip Marek ◽  
Zdenek Kala ◽  
Vladimir Prochazka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Duration ◽  
Resection Margins ◽  
Endoscopic Recurrence ◽  
Histological Results ◽  
Resected Bowel ◽  
Microscopic Inflammation

Abstract Background and Aims The pathogenesis and risk factors for early postoperative endoscopic recurrence of Crohn’s disease [CD] remain unclear. Thus, this study aimed to identify whether histological inflammation at the resection margins after an ileocaecal resection influences endoscopic recurrence. Methods We have prospectively followed up patients with CD who underwent ileocaecal resection at our hospital between January 2012 and January 2018. The specimens were histologically analysed for inflammation at both of the resection margins [ileal and colonic]. We evaluated whether histological results of the resection margins are correlated with endoscopic recurrence of CD based on colonoscopy 6 months after ileocaecal resection. Second, we assessed the influence of known risk factors and preoperative therapy on endoscopic recurrence of CD. Results A total of 107 patients were included in our study. Six months after ileocaecal resection, 23 patients [21.5%] had an endoscopic recurrence of CD. The histological signs of CD at the resection margins were associated with a higher endoscopic recurrence [56.5% versus 4.8%, p < 0.001]. Disease duration from diagnosis to surgery [p = 0.006] and the length of the resected bowel [p = 0.019] were significantly longer in patients with endoscopic recurrence. Smoking was also proved to be a risk factor for endoscopic recurrence [p = 0.028]. Conclusions Histological inflammation at the resection margins was significantly associated with a higher risk of early postoperative endoscopic recurrence after an ileocaecal resection for CD.

scholarly journals Upper Gastrointestinal Tract Involvement in Crohn’s Disease: Frequency, Risk Factors, and Disease Course

2018 ◽  
Vol 12 (12) ◽  
pp. 1399-1409 ◽  
Author(s):  
Thomas Greuter ◽  
Alberto Piller ◽  
Nicolas Fournier ◽  
Ekaterina Safroneeva ◽  
Alex Straumann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Gastrointestinal Tract ◽  
Crohn's Disease ◽  
Upper Gastrointestinal Tract ◽  
Disease Course ◽  
Tract Involvement ◽  
Upper Gastrointestinal

scholarly journals Risk Factors for Early Postoperative Complications after Surgery for Crohn's Disease

2014 ◽  
Vol 31 (3) ◽  
pp. 147-154 ◽  
Author(s):  
Vladimir Joksimović ◽  
Aleksandar Karagjozov ◽  
Gjorgi Jota ◽  
Ilija Milev ◽  
Radomir Gelevski
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Medical Centre ◽  
Resection Margins ◽  
Digestive Surgery ◽  
Early Postoperative Complications ◽  
Using Data ◽  
The University

Summary The aim of this study was to show the influence of various risk factors on early postoperative complications following surgery for Crohn’s disease (CD). In this review, an online internet database was searched, and also systematic review of the literature was performed. Three different studies from different countries were analyzed and compared with the results obtained in our University Clinic of Digestive Surgery - Skopje. The first review shows the influence of positive resection margins in CD on septical complications occurrence in patients undergoing ileocolic resection for CD at the Tel Aviv Medical Centre - Israel. The second review shows the risk factors for complications after bowel surgery in Korean patients with CD using data from the Asan Medical Centre - Seul, Korea. The third review shows that the delay of surgery is associated with inferior postoperative outcome in patients treated for perforating Crohn’s ileitis, and the study was conducted using data from the medical records of patients treated at the Department of Surgery at the University of Regensburg, Germany. Finally, we analyzed the influence of the most common risk factors on early postoperative complications in patients that underwent surgery for Crohn’s disease in a five-year period at the University Clinic of Digestive Surgery in Skopje, Macedonia and compared them with the results in the aforementioned articles.

scholarly journals Adalimumab and azathioprine in the prevention of postoperative crohn’s disease recurrence

2020 ◽  
pp. 128-133
Author(s):  
A. V. Poletova ◽  
M. V. Shapina
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Surgical Treatment ◽  
Crohn's Disease ◽  
Conservative Therapy ◽  
Biological Therapy ◽  
Combined Therapy ◽  
Laboratory Data ◽  
Disease Recurrence ◽  
Preventive Therapy

Introduction. Despite improvements in earlier diagnosis and the development of conservative therapy for Crohn’s disease (CD), approximately 70%–80% of patients undergo surgical treatment for complications. Surgical treatment is not a cure for this disease. The question of choosing therapy as a prevention of postoperative relapse of CD is still open. AIM. To compare the effectiveness of immunosuppressive and biological therapy as a postoperative preventive therapy.Materials and methods. The retrospective study included 125 patients with CD who underwent surgery in terms from 2010 to 2017. After the operation, patients were divided into 3 groups. Patients from the first group received azathioprine, from the second - adalimumab, and patients from the third group were prescribed combined therapy with azathioprine and adalimumab. Clinical, endoscopic, and laboratory data for analysis of disease activity was collected 3, 6, and 12 months after surgery.Results. During the year of therapy in all three groups relapses occurred in only 22 patients (22/125 17.6%). There were no statistically significant differences between the groups at any of the assessment stages. There was also no statistically significant correlation between the presence of risk factors and relapses.Conclusion. Our research has shown that the choice of anti-relapse therapy depending on risk factors is controversial. However, active endoscopic monitoring is important regardless of the treatment strategy. Also, our data allow us to conclude that the frequency of relapses of CD during the postoperative preventive therapy does not depend on the specific drug chosen, as well as on demographic and anamnestic parameters.

On-table endoscopy to define strictures and resection margins: experience from 178 operations for Crohn's disease using intraoperative endoscopy

2001 ◽  
Vol 3 (Supplement 2) ◽  
pp. 58-62
Author(s):  
G. Olaison ◽  
P. Andersson ◽  
P. Myrelid ◽  
K. Smedh ◽  
J. Soderholm ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Resection Margins ◽  
Intraoperative Endoscopy

scholarly journals Cross-disorder analysis of schizophrenia and 19 immune-mediated diseases identifies shared genetic risk

2019 ◽  
Vol 28 (20) ◽  
pp. 3498-3513 ◽  
Author(s):  
Jennie G Pouget ◽  
Buhm Han ◽  
Yang Wu ◽  
Emmanuel Mignot ◽  
Hanna M Ollila ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Genetic Risk ◽  
Genetic Risk Factors ◽  
Phenotypic Correlation ◽  
Biliary Cirrhosis ◽  
Genome Wide ◽  
Shared Genetic

Abstract Many immune diseases occur at different rates among people with schizophrenia compared to the general population. Here, we evaluated whether this phenomenon might be explained by shared genetic risk factors. We used data from large genome-wide association studies to compare the genetic architecture of schizophrenia to 19 immune diseases. First, we evaluated the association with schizophrenia of 581 variants previously reported to be associated with immune diseases at genome-wide significance. We identified five variants with potentially pleiotropic effects. While colocalization analyses were inconclusive, functional characterization of these variants provided the strongest evidence for a model in which genetic variation at rs1734907 modulates risk of schizophrenia and Crohn’s disease via altered methylation and expression of EPHB4—a gene whose protein product guides the migration of neuronal axons in the brain and the migration of lymphocytes towards infected cells in the immune system. Next, we investigated genome-wide sharing of common variants between schizophrenia and immune diseases using cross-trait LD score regression. Of the 11 immune diseases with available genome-wide summary statistics, we observed genetic correlation between six immune diseases and schizophrenia: inflammatory bowel disease (rg = 0.12 ± 0.03, P = 2.49 × 10−4), Crohn’s disease (rg = 0.097 ± 0.06, P = 3.27 × 10−3), ulcerative colitis (rg = 0.11 ± 0.04, P = 4.05 × 10–3), primary biliary cirrhosis (rg = 0.13 ± 0.05, P = 3.98 × 10−3), psoriasis (rg = 0.18 ± 0.07, P = 7.78 × 10–3) and systemic lupus erythematosus (rg = 0.13 ± 0.05, P = 3.76 × 10–3). With the exception of ulcerative colitis, the degree and direction of these genetic correlations were consistent with the expected phenotypic correlation based on epidemiological data. Our findings suggest shared genetic risk factors contribute to the epidemiological association of certain immune diseases and schizophrenia.

scholarly journals Capsule Retentions and Incomplete Capsule Endoscopy Examinations: An Analysis of 2300 Examinations

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Charlotte M. Höög ◽  
Lars-Åke Bark ◽  
Juan Arkani ◽  
Jacob Gorsetman ◽  
Olle Broström ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Capsule Endoscopy ◽  
Male Gender ◽  
Large Series ◽  
Older Age ◽  
Safe Procedure ◽  
Capsule Retention

Aim. To evaluate capsule endoscopy in terms of incomplete examinations and capsule retentions and to find risk factors for these events.Material and Methods. This retrospective and consecutive study includes data from 2300 capsule enteroscopy examinations, performed at four different hospitals in Stockholm, Sweden from 2003 to 2009.Results. The frequency of incomplete examinations was 20%. Older age, male gender, suspected, and known Crohn's disease were risk factors for an incomplete examination. The PillCam capsule had the highest rate of completed examinations. Capsule retention occurred in 1.3% (). Risk factors for capsule retention were known Crohn's disease and suspected tumor. Complications of capsule retention were acute obstructive symptoms in six patients and one death related to complications after acute surgical capsule retrieval.Conclusion: Capsule endoscopy is considered a safe procedure, although obstructive symptoms and serious complications due to capsule retention can be found in a large series of patients.

scholarly journals Management of Crohn’s disease in an immunosuppressed COVID-19-positive patient: safety-driven prioritisation of nutritional therapy as a bridge to restarting immunosuppression

2021 ◽  
Vol 14 (3) ◽  
pp. e239404
Author(s):  
Clare Harris ◽  
Richard James Harris ◽  
Louise Downey ◽  
Markus Gwiggner
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Patient Safety ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Nutritional Therapy ◽  
Interleukin 12 ◽  
Inflammatory Bowel ◽  
Term Maintenance

Active inflammatory bowel disease (IBD), combined immunosuppression and corticosteroid therapy have all been identified as risk factors for a poor outcome in COVID-19 infection. The management of patients with both COVID-19 infection and active IBD is therefore complex. We present the case of a 31-year-old patient with Crohn’s disease, on dual immunosuppression with infliximab and mercaptopurine presenting with inflammatory small bowel obstruction and COVID-19 infection. The case highlights the use of nutritional therapy, which remains underused in the management of adults with IBD, to manage his flare acutely. Following negative SARS-CoV-2 PCR testing and SARS-CoV-2 IgG testing confirming an antibody response, ustekinumab (anti-interleukin 12/23) was prescribed for long-term maintenance.

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