Endoscopic ultrasound to guide the combined medical and surgical management of pediatric perianal Crohnʼs disease

Rosen, Michael J.; Moulton, Dedrick E.; Koyama, Tatsuki; Morgan, Walter M.; Morrow, Stephen E.; Herline, Alan J.; Muldoon, Roberta L.; Wise, Paul E.; Polk, D. Brent; Schwartz, David L.

doi:10.1002/ibd.21067

Cited by 45 publications

(35 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Pelvic magnetic resonance imaging and rectal endoscopic ultrasonography in centers with expertise are the preferred modalities for evaluating perianal abscesses and fistulas. 32 …”

Section: Diagnosismentioning

confidence: 99%

Inflammatory Bowel Disease in Children and Adolescents

2015

Self Cite

View full text Add to dashboard Cite

“…Pelvic magnetic resonance imaging and rectal endoscopic ultrasonography in centers with expertise are the preferred modalities for evaluating perianal abscesses and fistulas. 32 …”

Section: Diagnosismentioning

confidence: 99%

Inflammatory Bowel Disease in Children and Adolescents

2015

Self Cite

View full text Add to dashboard Cite

“…While many studies have attempted to identify factors to predict risk of surgical intervention in children with CD, few have specifically evaluated PF-CD. Not surprisingly, it appears likely that development of PF-CD may confer increased need of surgical intervention owing to the development of abscesses or fistulae [7]. …”

mentioning

confidence: 99%

Distinct phenotypes of children with perianal perforating Crohn’s disease

Short¹,

Dubinsky²,

Rabizadeh³

et al. 2013

Journal of Pediatric Surgery

View full text Add to dashboard Cite

Purpose Perianal perforating disease (PF) has been reported in approximately 15% of children with Crohn’s disease (CD). It is unknown whether children who present with PF at the time of diagnosis have a different course than those that develop PF while on therapy. Methods From a prospective, single institution observational registry of children diagnosed with CD, we identified children with perianal perforating CD, defined as perianal abscesses and/or fistulae. Patients who presented with perianal perforating CD (PF-CD0) were compared to those who developed perianal perforating CD (PF-CD1) after initial diagnosis. Results Thirty-eight of 215 (18%) children with CD had PF-CD during a median follow up of 4.5 years. Patients with PF-CD0 (n = 26) tended to be more likely male (81% vs. 50%, p = 0.07) and younger (9.3 yrs vs. 12.5 yrs, p = 0.02). PF-CD1 (n = 12) patients were more likely to require diverting ileostomy (42% vs. 8%, p = 0.02) and colectomy (33% vs. 4%, p = 0.03). Multivariable analysis predicted increased rate of diverting ileostomy in the PF-CD1 group (p = 0.007, OR 19.1, 95% CI 1.6–234.8). Conclusion Pediatric CD patients who develop PF while on therapy for CD have a more severe phenotype and are more likely to require diverting ileostomy or colectomy compared to those who present with PF-CD.

show abstract

“…The effectiveness of EUS in pediatric patients has recently been reported, and this is relevant when considering the high rate of patients being observed with inflammatory bowel disease in the developmental age [27–29]. Concerning EUS, this technique has now been implemented with 3D image reconstruction, allowing better identification of the relationship between the fistula and the sphincter complex.…”

Section: Classification and Preoperative Assessmentmentioning

confidence: 99%

Surgical Treatment of Perianal Fistulizing Crohn’s Disease: From Lay-Open to Cell-Based Therapy—An Overview

Pellino

Selvaggi

2014

The Scientific World Journal

View full text Add to dashboard Cite

Background. Perianal Crohn's disease (CD) can be challenging. Despite the high incidence of fistulizing CD, literature lacks clear guidelines. Several medical, surgical, and combined treatment modalities have been proposed, but evidences are scarce. Methods. We searched the literature to assess the facets of perianal CD, with particular focus on complex fistulae. Disease epidemiology, classification, diagnosis, activity scoring systems, and medical-surgical treatments were assessed. Results. Perianal fistulizing CD is common, frequently associated with upper gastrointestinal and colorectal CD. Complex fistulas often require repeated treatments. Continence is a major concern when dealing with repeated procedures. A prudent pathway is to resolve active sepsis and to limit damages, delaying a definitive treatment to the time when acute phase has been controlled. The improved diagnostic techniques allow better preoperative planning and are useful in monitoring the response to treatment. Besides newer devices, cell-based treatments are promising tools which have recently enriched the treatment portfolio. However, the need for proctectomy is still disturbingly high in CD patients with complex perianal fistulae. Conclusions. Perianal CD can impair quality of life and lead to need for proctectomy. A staged approach is reasonable. Treatment success can be improved by multimodal treatment and collaborative management by experienced gastroenterologists and surgeons.

show abstract

Endoscopic ultrasound to guide the combined medical and surgical management of pediatric perianal Crohnʼs disease

Cited by 45 publications

References 26 publications

Inflammatory Bowel Disease in Children and Adolescents

Inflammatory Bowel Disease in Children and Adolescents

Distinct phenotypes of children with perianal perforating Crohn’s disease

Surgical Treatment of Perianal Fistulizing Crohn’s Disease: From Lay-Open to Cell-Based Therapy—An Overview

Contact Info

Product

Resources

About