Occurrence of Crohn’s Disease in Children After Total Colectomy for Ulcerative Colitis

Postoperative Complications Following Colectomy for Ulcerative Colitis in Children

“…A change in diagnosis as an outpatient would not reflect an error in coding UC during hospital admission for colectomy. The 9% diagnosis change is in keeping with the reported diagnosis of CD after colectomy for children with UC ranging from 3% to 16% (20)(21)(22). Because we did not have an unselected control group, specificity and negative predictive values were not determined; however, owing to the rare incidence of colectomy for UC in children, the specificity and negative predictive values are likely high.…”

Management of Paediatric Ulcerative Colitis, Part 1

“…In those undergoing IPAA, the diagnosis of UC may change to CD; $15% in adult series (299,302,303,323) and 11 of 128 children (9%) in a recent multicenter pediatric study from the Paediatric IBD Porto group of ESPGHAN (324,325). Threestage IPAA has been used to reduce these complications in children with IBDU.…”

“…Restorative procto-colectomy and IPAA/IRA with covering ileostomy can be performed as a combined first stage for most ''ambulatory'' elective UC cases. The covering ileostomy is reversed several months later after confirmed healing of the pouch (299)(300)(301)(302)(303). Three-stage surgery (subtotal colectomy and ileostomy first) is recommended for ASC, for example, where the pre-operative PUCAI is >45, or in those on high-dose pre-operative steroids (prednisolone >0.20 mg Á kg À1 Á day À1 ) (36,301).…”

Long‐term Outcomes After Surgery on Pediatric Patients With Crohn Disease

“…In children, CD often presents as pancolitis (19), which makes a differential diagnosis of ulcerative colitis (UC) difficult and misdiagnoses are common (19)(20)(21)(22)(23)(24). Of patients with a primary diagnosis of UC who have undergone proctocolectomy with ileal pouch anal anastomosis formation, 13% eventually were diagnosed as having CD a mean of 2 years after the primary operation (25). In patients with pediatric-onset CD, the effects of small bowel resection or colectomy on quality of life (QoL), later development, and health have not been systematically studied.…”