Massive, Life-Threatening Bleeding in Crohn’s Disease

Kostka, R; Lukáš, Milan

doi:10.1080/00015458.2005.11679692

Cited by 29 publications

(13 citation statements)

References 22 publications

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“…[58][59][60][61] If the bleeding is too brisk to permit adequate endoscopic visualization or the source of hemorrhage cannot be identified, mesenteric angiography can be attempted and the bleeding site might be embolized. 58,61,62 Patients who are hemodynamically unstable or fail to respond to these measures usually require laparotomy, sometimes with intraoperative endoscopy, and resection of the responsible bowel segment. 63 Patients with Crohn's disease are at increased risk for malignancy at the sites of intestinal inflammation.…”

Section: Operative Indicationsmentioning

confidence: 99%

Practice Parameters for the Surgical Management of Crohn's Disease

Strong¹,

Koltun²,

Hyman³

et al. 2007

Diseases of the Colon &Amp; Rectum

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Section: Operative Indicationsmentioning

confidence: 99%

Practice Parameters for the Surgical Management of Crohn's Disease

Strong¹,

Koltun²,

Hyman³

et al. 2007

Diseases of the Colon &Amp; Rectum

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“…Střevní perforace byla kazuisticky popsána též u pacientů s komplikovanou CN, léčených biologickou léčbou (anti-TNFα). Předpokládaným s CN objevuje velmi zřídka (méně než v 1 %) [45][46][47][48][49][50][51].…”

Section: Akutní Indikace K Operaci Pro Crohnovu Nemoc 11 Volná Perfounclassified

“…Je nezbytné pokusit se zdroj lokalizovat a vyloučit krvácení z gastroduodenálního vředu. Endoskopické či radiologické ošetření je méně invazivní než operace, a proto je preferováno [45][46][47][48][49][50][51]. V posledních letech byla kazuisticky použita k rychlému zhojení krvácející léze bio logická léčba [52,53].…”

Section: Akutní Indikace K Operaci Pro Crohnovu Nemoc 11 Volná Perfounclassified

Recommendation of surgical treatment in patients with inflammatory bowel diseases – part 2: Crohn̕s disease

Šerclová¹,

Ryska²,

Bortlík³

et al. 2015

Gastroent Hepatol

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Souhrn: Chirurgická léčba Crohnovy nemoci je součástí péče o nemocné, kteří jsou primárně léčeni gastroenterologem. Znalost principů chirurgické léčby a indikací k operacím přispívá ke kvalitě péče o tyto nemocné. Proto členové Pracovní skupiny pro IBD při České gastroenterologické společnosti a Sekce IBD chirurgie při České chirurgické společnosti vytvořili na základě dostupné literatury doporučení pro chirurgickou léčbu. Doporučené postupy chirurgické léčby Crohnovy nemoci navazují na 1. část: Předoperační příprava. Práce se zabývá akutními a elektivními indikacemi k operacím, postupy dle jednotlivých lokalizací Crohnovy nemoci, technickými chirurgickými aspekty specifickými pro Crohnovu nemoc a komplikacemi po operaci. Klíčová slova: doporučený postup-chirurgická léčba-Crohnova nemoc Summary: Surgical treatment of Crohn´s disease is a part of care of patients primary treated by gastroenterologist. Understanding of surgical principles and indications to surgery improves the quality of care. Therefore, members of IBD Working group of Czech Society of Gastroenterology and Section of IBD Surgery of Czech Surgical Society created guidelines based on recent literature. These guidelines follow previously published 1 st part: Preoperative preparation. Content of this article covers emergent and elective indication to surgery, site specific surgical procedures in Crohn´s disease, description of proper techniques and postoperative complications treatment.

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“…More recently, Kostka et al [22] characterized the clinical features and course of 11 separate episodes of severe haemorrhage in six of 156 patients with CD (3.8%), treated between 1985 and 2003 at their institution. Emergency surgery was necessary to stop the primary or recurrent haemorrhage in four patients.…”

Section: Non-surgical Ibd Patientsmentioning

confidence: 99%

Blood transfusion for the treatment of acute anaemia in inflammatory bowel disease and other digestive diseases

García-Erce¹,

Gomollón²,

Múñoz³

2009

WJG

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Allogeneic blood transfusion (ABT) is frequently used as the first therapeutic option for the treatment of acute anaemia in patients with inflammatory bowel disease (IBD), especially when it developed due to gastrointestinal or perioperative blood loss, but is not risk-free. Adverse effects of ABT include, but are not limited to, acute hemolytic reaction (wrong blood or wrong patient), febrile non-hemolytic transfusional reaction, bacterial contamination, transfusion-related acute lung injury, transfusion associated circulatory overload, transfusion-related immuno-modulation, and transmission of almost all infectious diseases (bacteria, virus, protozoa and prion), which might result in increased risk of morbidity and mortality. Unfortunately, the main physiological goal of ABT, i.e. to increase oxygen consumption by the hypoxic tissues, has not been well documented. In contrast, the ABT is usually misused only to increase the haemoglobin level within a fixed protocol [mostly two by two packed red blood cell (PRC) units] independently of the patient' s tolerance to normovolemic anaemia or his clinical response to the transfusion of PRC units according to a "one-by-one" administration schedule. Evidencebased clinical guidelines may promote best transfusion practices by implementing restrictive transfusion protocols, thus reducing variability and minimizing the avoidable risks of transfusion, and the use of autologous blood and pharmacologic alternatives. In this regard, preoperative autologous blood donation (PABD) consistently diminished the frequency of ABT, although its contribution to ABT avoidance is reduced when performed under a transfusion protocol. In addition, interpretation of utility of PABD in surgical IBD patients is hampered by scarcity of published data. However, the role of autologous red blood cells as drug carriers is promising. Finally, it must be stressed that a combination of methods used within wellconstructed protocols will offer better prospects for blood conservation in selected IBD patients undergoing elective surgery.

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Massive, Life-Threatening Bleeding in Crohn’s Disease

Cited by 29 publications

References 22 publications

Practice Parameters for the Surgical Management of Crohn's Disease

Practice Parameters for the Surgical Management of Crohn's Disease

Recommendation of surgical treatment in patients with inflammatory bowel diseases – part 2: Crohn̕s disease

Blood transfusion for the treatment of acute anaemia in inflammatory bowel disease and other digestive diseases

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