Combination Biological and Surgical Therapy in an Adolescent Presenting With Highly Destructive Perianal Crohn Disease

Klinger, Aaron; Schursky, Melvin; Rosh, Joel R.; Starker, Isaac; Mercer, Geraldine O; Rolandelli, Rolando H.

doi:10.1097/mpg.0b013e3181d32728

Cited by 1 publication

(2 citation statements)

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“…They identified 67 of 230 patients (29%) (children and adolescents) with perianal disease of which only 6 (2.6% of total children) were described with HDPD. Since then there have been a few other case reports highlighting the severity of the condition and difficulty of treatment (222)(223)(224)(225). It is characterized by visualization of deep perianal ulceration and tissue destruction associated with copious exudate with involvement of perineum and surrounding areas.…”

Section: Diagnostic Approachmentioning

confidence: 99%

“…Unfortunately, HDPD is not particularly responsive to medical therapies including hyperbaric oxygen even with the advent of biologics and often diverting the fecal stream via an ostomy to promote perianal healing is the only effective form of management. Successful skin grafting of the perianal ulceration following fecal stream diversion has been described (223,225). Practice points:…”

Section: Diagnostic Approachmentioning

confidence: 99%

See 1 more Smart Citation

Surgical Management of Crohn Disease in Children

Amil‐Dias

Kolaček

Turner

et al. 2017

J. pediatr. gastroenterol. nutr.

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The incidence of Crohn disease (CD) has been increasing and surgery needs to be contemplated in a substantial number of cases. The relevant advent of biological treatment has changed but not eliminated the need for surgery in many patients. Despite previous publications on the indications for surgery in CD, there was a need for a comprehensive review of existing evidence on the role of elective surgery and options in pediatric patients affected with CD. We present an expert opinion and critical review of the literature to provide evidence-based guidance to manage these patients. Indications, surgical options, risk factors, and medications in pre- and perioperative period are reviewed in the light of available evidence. Risks and benefits of surgical options are addressed. An algorithm is proposed for the management of postsurgery monitoring, timing for follow-up endoscopy, and treatment options.

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Section: Diagnostic Approachmentioning

confidence: 99%

Section: Diagnostic Approachmentioning

confidence: 99%