Montreal classification of patient operated for Crohn's disease and identification of surgical recurrence predictors

Inflammatory Bowel Disease: Outpatient Treatment Profile

“…If there is a simultaneous proximal (L4) and distal (L1-L3) involvement, an L4 category should be added as a modifier; if no distal involvement was found, L4 was considered to be of the exclusive form. This resulted in seven possible classifications according to location: L1, L2, L3, L4, L1+L4, L2+L4, and L3+L4 (4,10) . Concerning the clinical behavior of CD, three classifications were used: nonstenotic and nonpenetrating/inflammatory (B1), stenotic (B2), and penetrating/fistulizing (B3).…”

“…On the other hand, stenotic behavior (B2) is defined by a narrowing of the intestinal lumen. Penetrating behavior (B3) is defined when abdominal fistulae or inflammatory masses and/or abscess occur at any period during the progression of disease (4,10,12,15) . To ensure correct classification and differentiation of the clinical behavior of CD, data from enterography reports obtained from magnetic resonance imaging or computed tomography scans were used preferentially, as well as endoscopic reports of the study patients when appropriate.…”

“…Among the various classifications proposed for UC and CD, the Montreal classification is the most commonly used as it distinguishes clinical subphenotypes of CD according to location, behavior, and age at symptom onset, and those of ulcerative colitis according to the extent of the disease and age at symptom onset. Such a classification is desirable for correlating specific disease phenotypes with possible clinical outcomes and prognosis to select a better therapeutic approach and a more appropriate follow-up for each patient (4,5) . Reference centers responsible for treating patients with IBD are often required to justify their need for resources in order to provide appropriate treatments for patients.…”

“…In Brazil, patients with CD and UC are not necessarily reported resulting in a lack of epidemiologic data with respect to these diseases. This situation places patients in a vulnerable state, as incipient studies and the poor publication records on this group of diseases contribute to their late diagnosis and increased morbidity (3,4,6,8,9,14) . It is difficult to determine the epidemiologic data of IBD in Brazil and all developing countries owing to deficiencies in data recording systems and the inability to access data other than those in the public health system.…”

Multiple healthcare-associated infections in a patient with Crohn's disease: Case report

“…The etiology is unknown and theories that have emerged involve bacterial infections, immunological and genetic factors, psychological and nutritional disorders, gastrointestinal allergy and environmental factors. 5 The most common symptoms are abdominal pain, bowel obstruction and diarrhea, often prompting individuals affected to corrective surgeries and long hospitalization periods, which increases the risk of infections. 5,6 The aim of this work was to evaluate and to describe an interesting case of a patient with DC and multiple HAIs, when microorganisms were isolated in different clinical specimens in a short period.…”