Medical and Surgical Management of Pediatric Ulcerative Colitis

Cabrera, José; Sato, Thomas T.

doi:10.1055/s-0037-1609021

Cited by 9 publications

(11 citation statements)

References 77 publications

(71 reference statements)

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“…Moreover, in pediatric patients, the pancolitis at onset is quite common with a natural course often more severe than for their adult counterparts. 16 Kelley-Quon et al 17 reported as predictive factors for colectomy a serum albumin less than 3.5 g/dL, significant weight loss at the time of diagnosis, and a first-degree relative with UC. Our patient had two of these predictive factors for colectomy in the future, and this, considering the underlying complex genitourinary–rectal malformation, is of a great concern.…”

Section: Discussionmentioning

confidence: 99%

Ulcerative Colitis of the Neovagina in a Toddler with Cloaca and Chronic Kidney Disease

Erculiani

Zanatta

Vidal

et al. 2021

European J Pediatr Surg Rep

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The case of a toddler with long-channel cloaca, mild chronic kidney disease (CKD) due to renal dysplasia, and early onset of ulcerative colitis (UC) is herein reported. The patient underwent definitive repair of cloaca, that included vaginal elongation with colon, at 5 months of age and was admitted for episodes of vaginal bleeding at 22 months of age. A vaginoscopy revealed a severe inflammation of the colonic neovagina. As rectal bleeding was also noticed, she underwent a colonscopy that showed the same macroscopic inflammatory picture. Neovaginal and colonic biopsies confirmed UC. The mother turned out to be affected by UC since adolescence. The patient is now on oral therapy with mesalazine and topical steroid and mesalazine in the neovagina. The association between cloaca and inflammatory bowel disease (IBD) is anecdotal, but the family history of IBD should be considered when planning the surgical reconstruction of patients with cloaca. In this patient, the occurrence of UC may require a new neovagina in the future and the concomitance of CKD may complicate the overall management due to the potential nephrotoxicity of drugs used for UC therapy.

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Section: Discussionmentioning

confidence: 99%

Ulcerative Colitis of the Neovagina in a Toddler with Cloaca and Chronic Kidney Disease

Erculiani

Zanatta

Vidal

et al. 2021

European J Pediatr Surg Rep

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“…Risk factors for toxic megacolon include CMV or C. difficile infection, hypokalemia, hypomagnesemia, and the use of drugs that decrease colonic motility, such as anticholinergics, narcotics, and antidepressants with anticholinergic properties (207) . Additionally, early discontinuation or rapid reduction of steroids or aminosalicylates and diagnostic procedures that can cause colonic distention (colonoscopy and barium enema) are also risk factors for the development of toxic megacolon (208) . Children with toxic megacolon should be treated by surgeons and conservative management should only be considered in stable clinical conditions and in highly specialized centers under close monitoring; urgent colectomy is recommended if no improvement is apparent within 24 to 72 hours (22) .…”

Section: Recommendationmentioning

confidence: 99%

Brazilian Consensus on the Management of Inflammatory Bowel Diseases in Pediatric Patients: A Consensus of the Brazilian Organization for Crohn’s Disease and Colitis (Gediib)

Lomazi

Oba

Rodrigues

et al. 2023

Arq. Gastroenterol.

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Background -Approximately 25% of patients with inflammatory bowel disease (IBD) develop the disease during childhood or adolescence and treatment aims to control active symptoms and prevent long-term complications. The management of Crohn's disease (CD) and ulcerative colitis (UC) can be especially challenging in children and adolescents, related to particularities that may affect growth, development, and puberty. Objective -This consensus aims to provide guidance on the most effective medical and surgical management of pediatric patients with CD or UC. Methods -Experts in Pediatric IBD representing Brazilian gastroenterologists (Brazilian Organization for Crohn's Disease and Colitis [GEDIIB]) developed this consensus. A rapid review was performed to support the recommendations/statements. Medical and surgical recommendations were structured and mapped according to the disease type, disease activity, and indications and contraindications for medical and surgical treatment. After structuring the statements, the modified Delphi Panel methodology was used to conduct the voting. The process took place in three rounds: two using a personalized and anonymous online voting platform and one face-to-face. Whenever participants did not agree with a specific recommendation, an option to explain why was offered to enable free-text responses and provide the opportunity for the experts to elaborate or explain disagreement. The consensus of recommendations in each round was accepted when reached ≥80% agreement. Results and conclusion -The recommendations are presented according to the stage of treatment and severity of the disease in three domains: management and treatment (drug and surgical interventions), criteria for evaluating the effectiveness of medical treatment, and follow-up/ patient monitoring after initial treatment, follow-up/ patient monitoring after initial treatment. Surgical recommendations were grouped according to disease type and recommended surgery. The target audience for this consensus was general practitioners, gastroenterologists, and surgeons interested in the treatment and management of pediatric CD and UC. Additionally, the consensus aimed to support the decision-making of health insurance companies, regulatory agencies, and health institutional leaders and/or administrators.

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“…Pediatric IBD patients should be screened frequently for these disorders, as well as for impairments in social functioning, and referred appropriately [13]. A surgeon should be consulted for those who fail medical management or have disease-related complications that require it, such as dysplasia, perforations, and obstructions [14,15].…”

Section: Multidisciplinary Approachmentioning

confidence: 99%

Pediatric Inflammatory Bowel Disease

Rotondo-Trivette

Michail

2021

Asp J Pediatrics Child Health

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Inflammatory bowel disease is an important pediatric disease, with as many as 25% of cases presenting during childhood. In this article, we review the types, etiology epidemiology, presentation, diagnosis, and management of pediatric inflammatory bowel disease. We also highlight the unique aspects of pediatric-onset inflammatory bowel disease versus adult-onset and future directions in this field, such as the use of genetic studies and ultrasound for the management of pediatric patients with inflammatory bowel disease.

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Medical and Surgical Management of Pediatric Ulcerative Colitis

Cited by 9 publications

References 77 publications

Ulcerative Colitis of the Neovagina in a Toddler with Cloaca and Chronic Kidney Disease

Ulcerative Colitis of the Neovagina in a Toddler with Cloaca and Chronic Kidney Disease

Brazilian Consensus on the Management of Inflammatory Bowel Diseases in Pediatric Patients: A Consensus of the Brazilian Organization for Crohn’s Disease and Colitis (Gediib)

Pediatric Inflammatory Bowel Disease

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