Risk factors and implications of anastomotic complications after surgery for Crohn’s disease

Abstract Background and Aims To compare perioperative characteristics and outcomes between primary ileocolonic resection [PICR] and iterative ileocolic resection [IICR] for Crohn’s disease [CD]. Methods From 2013 to 2015, 567 patients undergoing ileocolonic resection were prospectively included in 19 centres of the GETAID chirurgie group. Perioperative characteristics and postoperative results of both groups [431 PICR, 136 IICR] were compared. Uni- and multivariate analyses of the risk factors of overall 30-day postoperative morbidity was carried out in the IICR group. Results IICR patients were less likely to be malnourished [27.2% vs 39.9%, p = 0.007], and had more stricturing forms [69.1% vs 54.3%, p = 0.002] and less perforating disease [19.9% vs 39.2%, p < 0.001]. Laparoscopy was less commonly used in IICR [45.6% vs 84.5%, p < 0.01] and was associated with increased conversion rates [27.4% vs 14.6%, p = 0.012]. Overall postoperative morbidity was 36.8% in the IICR group and 26.7% in the PICR group [p = 0.024]. There was no significant difference between IICR and PICR regarding septic intra-abdominal complications, anastomotic leakage [8.8% vs 8.4%] or temporary stoma requirement. IICR patients were more likely to present with non-infectious complications and ileus [11.8% vs 3.7%, p < 0.001]. Uni- and multivariate analyses did not identify specific risk factors of overall postoperative morbidity in the IICR group. Conclusions Surgery for recurrent CD is associated with a slight increase of non-infectious morbidity [postoperative ileus] that mainly reflects the technical difficulties of these procedures. However, IICR remains a safe therapeutic option in patients with recurrent CD because severe morbidity including anastomotic complications is similar to patients undergoing primary resection. Podcast This article has an associated podcast which can be accessed at https://academic.oup.com/ecco-jcc/pages/podcast

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

Human Molecular Genetics ◽

10.1093/hmg/ddz145 ◽

2019 ◽

Vol 28 (20) ◽

pp. 3498-3513 ◽

Cited By ~ 15

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.

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P368. Risk factors for serious infections in elderly patients receiving infliximab and other Crohn’s disease therapies: TREAT™ registry data

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjw019.487 ◽

2016 ◽

Vol 10 (suppl 1) ◽

pp. S283.1-S283

Keyword(s):

Risk Factors ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Elderly Patients ◽

Registry Data ◽

Serious Infections

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

Gastroenterology Research and Practice ◽

10.1155/2012/518718 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 76

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.

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Systematic review with meta-analysis: The prevalence, risk factors and outcomes of upper gastrointestinal tract crohn's disease

Digestive and Liver Disease ◽

10.1016/j.dld.2021.07.037 ◽

2021 ◽

Author(s):

Yip Han Chin ◽

Cheng Han Ng ◽

Snow Yunni Lin ◽

Sneha Rajiv Jain ◽

Gwyneth Kong ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Crohn’S Disease ◽

Gastrointestinal Tract ◽

Crohn's Disease ◽

Meta Analysis ◽

Upper Gastrointestinal Tract ◽

Upper Gastrointestinal

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

BMJ Case Reports ◽

10.1136/bcr-2020-239404 ◽

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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