Perianal Crohn's Disease

Safar, Bashar; Sands, Dana R.

doi:10.1055/s-2007-991027

Cited by 60 publications

(34 citation statements)

References 40 publications

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“…In our review, 7 of 13 (54%) CD patients had undergone surgery in their medical history with a mean time of clinical latency between the diagnosis and the first operation of 7 (1-12) years. Previous studies have shown similar results [26,27,28,29,30,31]. …”

Section: Discussionsupporting

confidence: 78%

Induction or Exacerbation of Psoriasis in Patients with Crohn's Disease under Treatment with Anti-TNF Antibodies

Barthel

Biedermann²,

Frei³

et al. 2014

Digestion

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Background and Aims: Paradoxically, psoriasis or psoriasiform skin lesions induced or exacerbated by anti-TNF antibodies have been described. Here, we report a series of 13 novel cases featuring exacerbation or occurrence of psoriatic skin lesions induced by anti-TNF antibodies in patients with Crohn's disease (CD). Methods: We performed a systematic analysis of exacerbation or occurrence of psoriasis or psoriasiform skin lesions induced by anti-TNF antibodies in an inflammatory bowel disease patient cohort at the University Hospital Zurich. Results: We identified 13 CD patients who developed psoriasis or psoriasiform lesions while receiving anti-TNF therapy. 10 of the 13 patients were female with an average age of 26.9 years at diagnosis. 11 of the 13 patients had a complicated disease. The mean time of clinical latency between diagnosis and onset of psoriasis was about 9.4 years, and the time between the beginning of all biological infusions and the onset of psoriasis was about 7 months. 7 of the 13 patients received infliximab, 3 adalimumab, and 3 certolizumab pegol at onset of psoriasis. In most of the cases, anti-TNF therapy was changed or discontinued and skin lesions improved. Conclusion: Most of our described patients featured a complicated disease course of CD and had an improvement of the rash after changing the anti-TNF therapy.

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Section: Discussionsupporting

confidence: 78%

Induction or Exacerbation of Psoriasis in Patients with Crohn's Disease under Treatment with Anti-TNF Antibodies

Barthel

Biedermann²,

Frei³

et al. 2014

Digestion

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“…3 Unfortunately, most patients with "temporary" diversion are unable to have their fecal continuity restored, and those that do have the stoma reversed have a high recurrence rate of symptoms. 70 Between 10% and 31% of patients with perianal CD eventually require proctectomy or permanent diversion. 56,70,71 The risks of permanent stoma are increased in patients who require temporary diversion, have more complex perianal disease, have had prior rectal resection, or who have issues with incontinence.…”

Section: Fecal Diversion or Proctectomymentioning

confidence: 99%

“…70 Between 10% and 31% of patients with perianal CD eventually require proctectomy or permanent diversion. 56,70,71 The risks of permanent stoma are increased in patients who require temporary diversion, have more complex perianal disease, have had prior rectal resection, or who have issues with incontinence. 71…”

Section: Fecal Diversion or Proctectomymentioning

confidence: 99%

The Evaluation and Treatment of Crohn Perianal Fistulae: EUA, EUS, MRI, and Other Imaging Modalities

Wise

Schwartz

2012

Gastroenterology Clinics of North America

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“…One in three of these patients will develop a perianal fistula2, of whom just one in three achieve long‐term healing of the fistula3. This is a condition that should be managed in concert between surgeon and physician4.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of surgical interventions for Crohn's anal fistula

Lee

Heywood²,

Adegbola

et al. 2017

BJS Open

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BackgroundAnal fistula occurs in approximately one in three patients with Crohn's disease and is typically managed through a multimodal approach. The optimal surgical therapy is not yet clear. The aim of this systematic review was to identify and assess the literature on surgical treatments of Crohn's anal fistula.MethodsA systematic review was conducted that analysed studies relating to surgical treatment of Crohn's anal fistula published on MEDLINE, Embase and Cochrane databases between January 1995 and March 2016. Studies reporting specific outcomes of patients treated for Crohn's anal fistula were included. The primary outcome was fistula healing rate. Bias was assessed using the Cochrane ROBINS‐I and ROB tool as appropriate.ResultsA total of 1628 citations were reviewed. Sixty‐three studies comprising 1584 patients were ultimately selected in the analyses. There was extensive reporting on the use of setons, advancement flaps and fistula plugs. Randomized trials were available only for stem cells and fistula plugs. There was inconsistency in outcome measures across studies, and a high degree of bias was noted.ConclusionData describing surgical intervention for Crohn's anal fistula are heterogeneous with a high degree of bias. There is a clear need for standardization of outcomes and description of study cohorts for better understanding of treatment options.

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Perianal Crohn's Disease

Cited by 60 publications

References 40 publications

Induction or Exacerbation of Psoriasis in Patients with Crohn's Disease under Treatment with Anti-TNF Antibodies

Induction or Exacerbation of Psoriasis in Patients with Crohn's Disease under Treatment with Anti-TNF Antibodies

The Evaluation and Treatment of Crohn Perianal Fistulae: EUA, EUS, MRI, and Other Imaging Modalities

Systematic review of surgical interventions for Crohn's anal fistula

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