Abdominal Emergencies in Inflammatory Bowel Disease

Goldstone, Robert N.; Steinhagen, Randolph

doi:10.1016/j.suc.2019.08.007

Cited by 37 publications

(40 citation statements)

References 45 publications

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“…Diagnosis of perforation in this setting may be delayed if the patient is on high-dose steroids or other immunosuppressants. In these settings, the appropriate management involves urgent resuscitation, administration of broad-spectrum antibiotics, and emergent surgical intervention [33].…”

Section: Ulcerative Colitis and Emergency Surgerymentioning

confidence: 99%

“…In emergent situations the recommended operation is colectomy and ileostomy, leaving the rectum intact, since reconstruction is not an option in the acute setting [34][35]. A total proctocolectomy should be avoided because it is associated with greater postoperative morbidity and mortality due to increased operative time, risk of blood loss, pelvic sepsis, pelvic nerve damage, and small bowel obstruction greater postoperative morbidity and mortality due to increased operative time, risk of blood loss, pelvic sepsis, pelvic nerve damage, and small bowel obstruction [33]. A three-stage procedure is conducted in patients with a considerably reduced general health condition, or in patients depending on high doses of steroid therapy as avoidance of proctectomy and ileal pouch formation avoids pelvic sepsis and higher risk of pouch failure [35].…”

Section: Ulcerative Colitis and Emergency Surgerymentioning

confidence: 99%

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Ulcerative Colitis: the Role of Elective and Emergency Surgery

Mulita

Iliopoulos

Liolis

et al. 2021

AJTES

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Inflammatory bowel disease (IBD) is a group of auto-inflammatory conditions characterized by chronic, remitting, and relapsing inflammation of the alimentary tract. It is comprised of two phenotypically different entities: Crohn’s disease, and ulcerative colitis (UC). The aim of this article is to explore the role of the general surgeon regarding the treatment of patients suffering from UC while presenting a case of a 55-year-old woman with low-differentiated colon adenocarcinoma associated with ulcerative colitis. Patients with UC have a high-risk of developing colorectal cancer. While medical treatment is commonly the initial approach to UC, surgery constitutes a major contributor in dealing with UC. Inflammatory bowel disease (IBD) is a group of auto-inflammatory conditions characterized by chronic, remitting, and relapsing inflammation of the alimentary tract. It is comprised of two phenotypically different entities: Crohn’s disease, and ulcerative colitis (UC). The aim of this article is to explore the role of the general surgeon regarding the treatment of patients suffering from UC while presenting a case of a 55-year-old woman with low-differentiated colon adenocarcinoma associated with ulcerative colitis. Patients with UC have a high-risk of developing colorectal cancer. While medical treatment is commonly the initial approach to UC, surgery constitutes a major contributor in dealing with UC. Case report. A 55-year-old female with hypertension and iron deficiency anemia presented to our emergency department with fever, diarrhea, and epigastric pain for 24 hours which was not associated with heartburn, vomiting, melena, or hematemesis. On examination, the patient’s temperature was 39oC, heart rate was 104 beats per minute, blood pressure was 108/65 and the respiratory rate was 20 breaths per minute. Her abdomen was soft, without distension, and with no evidence of palpable mass...

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Section: Ulcerative Colitis and Emergency Surgerymentioning

confidence: 99%

Section: Ulcerative Colitis and Emergency Surgerymentioning

confidence: 99%

Ulcerative Colitis: the Role of Elective and Emergency Surgery

Mulita

Iliopoulos

Liolis

et al. 2021

AJTES

View full text Add to dashboard Cite

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“…This may be endoscopic or surgical. 5 Acute strictures are characterized by bowel wall edema as compared with the fibrosis of a chronic stricture. The acuity can often be differentiated on high-quality imaging such as CTE (computed tomography enterography) and MRE (magnetic resonance enterography), which have dramatically improved in recent years.…”

Section: Epidemiology Acute Obstructionmentioning

confidence: 99%

“…Small bowel strictures are less likely to be malignant, however, if a large bowel stricture or obstruction occurs, one should always keep malignancy on the radar. 5 The majority of Crohn's obstructions are from chronic strictures that are fibrotic in nature (►Fig. 1a-c).…”

Section: Chronic Obstructionmentioning

confidence: 99%

“…Ballooning success rates have been reported as high as 89 to 92% with up to 81% of patients having at least short-term relief of symptoms. 5 This relief does go down over time with long-term results showing 43% eventually undergo surgery. In general, strictures ideal for endoscopic balloon dilation are those that are accessible endoscopically, those with a length of 5 cm, and those that are considered "nonangulated" or are relatively straight.…”

Section: Endoscopic Managementmentioning

confidence: 99%

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Crohn's Disease Obstructions

Ford

2021

Clin Colon Rectal Surg

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Obstruction from stricturing Crohn's disease remains one of the most common reasons for intervention. Acute inflammation is often responsive to medications, but chronic fibrosis is unlikely to respond and will generally go on to require additional treatment. Newer methods, such as endoscopic balloon dilation, are gaining grounds in strictures that are amenable, but with high recurrence and strictures that may not be endoscopically accessible, surgery still plays a key role in the treatment of obstructing Crohn's disease.

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Crohn’s Disease: Surgical Management

Cannon

Fichera

2021

The ASCRS Textbook of Colon and Rectal Surgery

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Abdominal Emergencies in Inflammatory Bowel Disease

Cited by 37 publications

References 45 publications

Ulcerative Colitis: the Role of Elective and Emergency Surgery

Ulcerative Colitis: the Role of Elective and Emergency Surgery

Crohn's Disease Obstructions

Crohn’s Disease: Surgical Management

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