scholarly journals Crohn’s disease manifested with massive colonic bleeding (review and a clinical case)

2021 ◽  
Vol 20 (3) ◽  
pp. 84-94
Author(s):  
A. O. Atroshchenko ◽  
A. V. Kolygin ◽  
M. M. Severova ◽  
L. I. Markushin
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Case ◽  
Treatment Approach ◽  
Rare Complication ◽  
Surgical Methods ◽  
Massive Gastrointestinal Bleeding ◽  
Unified Algorithm ◽  
Colonic Bleeding ◽  
Inflammatory Bowel

Massive gastrointestinal bleeding (GIB) is a rare complication of Crohn’s disease (CD). For the recent decades a number of medical and surgical methods to control the GIB have been introduced. However, the unified algorithm and approach to this subset of patients is still lacking, mostly due to the absence of adequately powered and wellconducted RCTs. Determining the optimal treatment approach to inflammatory bowel disease (IBD) in patients who develop a GIB is still a valid research target.

scholarly journals Crohn’s disease manifested with massive colonic bleeding (review and a clinical case)

2021 ◽  
Vol 20 (3) ◽  
pp. 84-94
Author(s):  
A. O. Atroshchenko ◽  
A. V. Kolygin ◽  
M. M. Severova ◽  
L. I. Markushin
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Case ◽  
Treatment Approach ◽  
Rare Complication ◽  
Surgical Methods ◽  
Massive Gastrointestinal Bleeding ◽  
Unified Algorithm ◽  
Colonic Bleeding ◽  
Inflammatory Bowel

Massive gastrointestinal bleeding (GIB) is a rare complication of Crohn’s disease (CD). For the recent decades a number of medical and surgical methods to control the GIB have been introduced. However, the unified algorithm and approach to this subset of patients is still lacking, mostly due to the absence of adequately powered and wellconducted RCTs. Determining the optimal treatment approach to inflammatory bowel disease (IBD) in patients who develop a GIB is still a valid research target.

scholarly journals Modern approaches to the treatment of inflammatory bowel disease in children according to the latest recommendations of the European Organization for the Study of Crohn's disease and colitis, and the European Society of Pediatric Gastroenterologists, Hepatologists and Nutritionists

2021 ◽  
pp. 40-57
Author(s):  
O.M. Okhotnikova ◽  
◽  
T.M. Tkacheva ◽  
A.A. Romanchuk ◽  
O.M. Grishchenko ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
European Society ◽  
Bowel Disease ◽  
Clinical Case ◽  
Young Patients ◽  
European Organization ◽  
Inflammatory Bowel

Modern outpatient management of ulcerative colitis (UC) continues to be a difficult task, as 20% of children still need colectomy (there are no official statistics for Ukraine). Therefore, the European Organization for the Study of Crohn's Disease and Colitis (ECCO) and the European Society of Pediatric Gastroenterologists, Hepatologists and Nutritionists (ESPGHAN), seeking to standardize the daily treatment of inflammatory bowel disease (IBD), have developed a protocol for the management and treatment of children with VC. Based on the analysis of medical research, followed by an evidentiary assessment of each provision, the 2012 recommendations were updated. The aim is to present the provisions of the updated protocol on therapeutic management of children with ulcerative colitis and to consolidate the material on a clinical case. Materials and methods. The article presents updated recommendations of ECCO and ESPGHAN (2018) on the treatment of COPD in children, the algorithm of induction and maintenance of remission of UC and COPD unclassified. A clinical case is given for an example of application of the algorithm of induction and support of remission of IBD at children, assessment of severity and the scheme of management of patients with this pathology is provided. Results and conclusions. The updated recommendations of ECCO and ESPGHAN facilitate the treatment of unclassified UC and IBD, provide a clear scheme for monitoring children with this pathology, which improves treatment outcomes and quality of life of young patients. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: ulcerative colitis, recommendations. children, anti-TNF, calprotectin, unclassified inflammatory bowel disease, monitoring, activity index, treatment.

scholarly journals Crohn’s disease with isolated gastric involvement as an example of a rare disease phenotype: a clinical case

2019 ◽  
Vol 47 (6) ◽  
pp. 592-602
Author(s):  
E. B. Avalueva ◽  
I. G. Bakulin ◽  
S. I. Sitkin ◽  
S. L. Vorobyev ◽  
I. A. Belyakov ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Gastrointestinal Tract ◽  
Crohn's Disease ◽  
Inflammatory Bowel Diseases ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Upper Gastrointestinal Tract ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Upper Gastrointestinal

Crohn's disease (CD), along with ulcerative colitis, is one of the predominant nosological forms of inflammatory bowel diseases. In CD, any part of the gastrointestinal tract can be affected; however, the process is commonly associated with terminal ileum or colon involvement. CD cases with isolated or mixed involvement of upper gastrointestinal tract (esophagus, stomach, and duodenum) are rare and least studied types of the disease. In isolated stomach involvement, the complaints are non-specific and include epigastric pain, gastric dyspepsia, early satiety, decreased appetite, and nausea. Isolated CD of upper gastrointestinal tract can be diagnosed after comprehensive work-up and always requires a high diagnostic level, including clinical, endoscopic and morphological one. We present a clinical case of CD with isolated stomach involvement in a 62-year-old woman. The diagnosis was confirmed by the histopathological findings of an epithelioid cell granuloma in the gastric antrum. Treatment with systemic corticosteroids reduced the disease clinical activity and improved the histological characteristics of the gastric biopsy sampled obtained by endoscopy. In this clinical case, there were specific macroscopic gastric lesions found at endoscopy in CD patients with upper gastrointestinal tract involvement, which is characterized by thickened longitudinal folding and linear grooves. This type of lesion has been described in the literature as “bamboo joint-like appearance”.Conclusion: Comprehensive assessment of clinical manifestations, endoscopic and histopathological specific features is crucial for the timely diagnosis and treatment of inflammatory bowel diseases.

scholarly journals Intestinal Intussusception as Crohn’s Disease Debut

2021 ◽  
Vol 2 (1) ◽  
pp. 57-59
Author(s):  
Edgar González-Gutiérrez
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Intestinal Obstruction ◽  
Clinical Case ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Ileocolic Intussusception ◽  
En Bloc ◽  
Inflammatory Bowel

Intussusception is a rare cause of intestinal obstruction in adults, occurring only in 5% of cases. Clinical case: a 22-year-old male patient with intestinal obstruction secondary to ileocolic intussusception as the onset of inflammatory bowel disease, who underwent en bloc resection of the affected segment. Keywords: Intussusception; Crohn’s disease

Localization and Activity of Inflammatory Bowel Disease Using 111ln Leukocyte Imaging

1988 ◽  
Vol 27 (03) ◽  
pp. 83-86 ◽  
Author(s):  
B. Briele ◽  
F. Wolf ◽  
H. J. Biersack ◽  
F. F. Knapp ◽  
A. Hotze
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Cell Uptake ◽  
Disease Extent ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Leukocyte Imaging

A prospective study was initiated to compare the clinically proven results concerning localization/extent and activity of inflammatory bowel diseases with those of 111ln-oxine leukocyte imaging. All patients studied were completely examined with barium enema x-ray, clinical and laboratory investigations, and endoscopy with histopathology. A total of 31 leukocyte scans were performed in 15 patients (12 with Crohn’s disease, 3 with ulcerative colitis). The scans were graded by comparing the cell uptake of a lesion (when present) and a bone marrow area providing a count ratio (CR). The inflammatory lesions were correctly localized on 26 leukocyte scans, and in 21 scans the scintigraphically estimated extent of disease was identical to endoscopy. In 5 cases the disease extent was underestimated, 4 scans in patients with relapse of Crohn’s disease were falsely negative, and in one patient with remission truly negative. The scintigraphically assessed disease activity was also in a good agreement with clinical disease activity based on histopathology in all cases. We conclude that leukocyte imaging provides valuable information about localization and activity of inflammatory bowel disease.

Quadriplegia, a Rare Complication of Pediatric Crohn's Disease, Successfully Treated with Endovascular Thromboembolectomy

PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 408A-408A
Author(s):  
Riana Riffle ◽  
Amro Abdulsattar ◽  
Sean Meagher ◽  
Girish Deshpande
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Rare Complication

Prebiotics and Probiotics in Inflammatory Bowel Disease: Where are we now and where are we going?

2020 ◽  
Vol 15 (3) ◽  
pp. 216-233 ◽  
Author(s):  
Maliha Naseer ◽  
Shiva Poola ◽  
Syed Ali ◽  
Sami Samiullah ◽  
Veysel Tahan
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Clinical Trials ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Adverse Effects ◽  
Bowel Disease ◽  
Relapse Prevention ◽  
Remission Induction ◽  
Inflammatory Bowel

The incidence, prevalence, and cost of care associated with diagnosis and management of inflammatory bowel disease are on the rise. The role of gut microbiota in the causation of Crohn's disease and ulcerative colitis has not been established yet. Nevertheless, several animal models and human studies point towards the association. Targeting intestinal dysbiosis for remission induction, maintenance, and relapse prevention is an attractive treatment approach with minimal adverse effects. However, the data is still conflicting. The purpose of this article is to provide the most comprehensive and updated review on the utility of prebiotics and probiotics in the management of active Crohn’s disease and ulcerative colitis/pouchitis and their role in the remission induction, maintenance, and relapse prevention. A thorough literature review was performed on PubMed, Ovid Medline, and EMBASE using the terms “prebiotics AND ulcerative colitis”, “probiotics AND ulcerative colitis”, “prebiotics AND Crohn's disease”, “probiotics AND Crohn's disease”, “probiotics AND acute pouchitis”, “probiotics AND chronic pouchitis” and “prebiotics AND pouchitis”. Observational studies and clinical trials conducted on humans and published in the English language were included. A total of 71 clinical trials evaluating the utility of prebiotics and probiotics in the management of inflammatory bowel disease were reviewed and the findings were summarized. Most of these studies on probiotics evaluated lactobacillus, De Simone Formulation or Escherichia coli Nissle 1917 and there is some evidence supporting these agents for induction and maintenance of remission in ulcerative colitis and prevention of pouchitis relapse with minimal adverse effects. The efficacy of prebiotics such as fructooligosaccharides and Plantago ovata seeds in ulcerative colitis are inconclusive and the data regarding the utility of prebiotics in pouchitis is limited. The results of the clinical trials for remission induction and maintenance in active Crohn's disease or post-operative relapse with probiotics and prebiotics are inadequate and not very convincing. Prebiotics and probiotics are safe, effective and have great therapeutic potential. However, better designed clinical trials in the multicenter setting with a large sample and long duration of intervention are needed to identify the specific strain or combination of probiotics and prebiotics which will be more beneficial and effective in patients with inflammatory bowel disease.

scholarly journals Immune Thrombocytopenic Purpura (ITP) as an Uncommon Extraintestinal Complication of Crohn’s Disease: Case Vignette and Systematic Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Raisa Epistola ◽  
Tiffanie Do ◽  
Ritika Vankina ◽  
Daniel Wu ◽  
James Yeh ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Immune Thrombocytopenic Purpura ◽  
Case Reports ◽  
Case Vignette ◽  
Mucosal Permeability ◽  
Extraintestinal Manifestation ◽  
Thrombocytopenic Purpura ◽  
Disease Case ◽  
Inflammatory Bowel

While the association of immune thrombocytopenic purpura (ITP) and inflammatory bowel disease (IBD) has been described in a few case reports, management of ITP as an extraintestinal manifestation of Crohn’s disease (CD) is less studied. There are approximately a dozen cases describing the management of patients dually diagnosed with CD/ITP. Previous reports postulated that the mechanism of ITP in CD was through the presence of circulating immune complexes in the serum and antigenic mimicry due to increased mucosal permeability in active colitis, versus increased mucosal production of TH1-type proinflammatory cytokines during CD flares, which may account for remission of ITP with surgery for CD. We present a case of a 27-year-old man who presented with medically refractory CD and ITP who responded to surgical management with colectomy and splenectomy, along with a systematic review of the literature. These cases suggest that colectomy should be considered in the treatment of medically refractory ITP among patients with concomitant CD.

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