Practice Parameters for the Surgical Management of Crohn's Disease

Strong, Scott A.; Koltun, Walter A.; Hyman, Neil; Buie, Donald

doi:10.1007/s10350-007-9012-7

Cited by 42 publications

(8 citation statements)

References 145 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: 76%

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: 76%

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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“…However, in cases refractory to medical treatment, in which the patient has extremely impaired QOL, with serious adverse reaction to drugs, or with a fibrous stenosis not expected to be improved by medical treatment, surgical treatment should be considered [57, 133]. The indication for the surgical treatment should not be determined only by the surgeon, but by thorough discussions involving the relevant healthcare providers together with the patient.…”

Section: V-6 Refractory Casesmentioning

confidence: 99%

Evidence-based clinical practice guidelines for Crohn’s disease, integrated with formal consensus of experts in Japan

et al. 2012

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Crohn’s disease is a disorder of unknown etiology and complicated pathogenesis. A substantial amount of evidence has accumulated recently and has been applied to clinical practice. The present guidelines were developed based on recent evidence and the formal consensus of experts relevant to this disease. Here we provide an overview of these guidelines, as follows.Target disease: Crohn’s diseaseUsers: Clinical practitioners in internal medicine, surgery, gastroenterology, and general practicePurpose: To provide appropriate clinical indicators to practitionersScope of clinical indicators: Concept of Crohn’s disease, epidemiology, classifications, diagnosis, treatment, follow up, and special situationsIntervention: Diagnosis (interview, physical examination, clinical laboratory tests, imaging, and pathology) and treatment (lifestyle guidance, drug therapy, nutritional therapy, surgery, etc.)Outcome assessment: Attenuation of symptoms, induction and maintenance of remission, imaging findings, quality of life (QOL), prevention of complications and harm of therapyMethods for developing these guidelines: Described in the textBasis of recommendations: Integration of evidence level and consensus of expertsCost-benefit analysis: Not implementedEvaluation of effectiveness: Yet to be confirmedStatus of guidelines: Updated version of the first Guidelines published in 2010Publication sources: Printed publication available and electronic information in preparationPatient information: Not availableDate of publication: October 2011These guidelines were intended primarily to be used by practitioners in Japan, and the goal of these guidelines is to improve the outcomes of patients with Crohn’s disease.

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“…In case of intra-abdominal abscess development, percutaneous drainage is primarily used in suitable patients, and surgical intervention might be required for others who are not suitable. However, to avoid life-threatening complications, deciding when to apply conservative treatment and when to perform surgical treatment and maintaining a rational approach towards the patient requires maximum attention (3). The patients' course of the disease can be regulated with regular medical treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Physical examination, laboratory tests, imaging studies, and endoscopic examinations are helpful for diagnosis (2). Conservative medical treatments are generally used, but some cases may require surgery, especially cases with intestinal obstruction, perforation, abscess, and fistula formation (3,4).…”

Section: Introductionmentioning

confidence: 99%

Crohn’s Disease Presenting as Acute Appendicitis, Case Series

Dinçel¹,

Başak²,

Kinaci³

et al. 2015

Istanbul Med J

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Objective: Crohn's disease can be observed in younger patients and may present with a clinical condition such as acute appendicitis. In this study, we aimed to investigate acute abdominal conditions that were caused by the first attack of Crohn's disease. Methods:Patients who were admitted with the signs of acute abdomen and underwent surgery between 2009 and 2013 were included in the study. Patients diagnosed with Crohn's disease based on intraoperative findings and postoperative evaluations were included in the study. Patient demographics, findings about Crohn's disease, and follow-up data were recorded.Results: During the study period, 736 patients who had acute abdomen and a preliminary diagnosis of acute appendicitis were operated, and four of them (0.5%) were diagnosed with Crohn's disease at the peroperative or postoperative period. Two of the patients were male and the others were female; the mean age was 36 years (28-45 years). Perioperative inflammatory cecal mass and local abscesses were observed in one patient and drainage was performed. Only appendectomy was performed in the other three patients, and postoperative enterocutaneous fistula was observed in two of them.Intestinal resection was performed in one of the patient with fistula, and the other responded well to medical treatment. Conclusion:Crohn's disease may present as acute abdomen. Particularly, people without a history of the illness may come to us with such a clinical condition in the first episode; therefore, this situation should not be ignored.Routine laboratory tests, complete blood count, chemistry panel, liver function tests, inflammatory markers and serologic tests were used to support the diagnosis of CD. Imaging methods such as plain abdominal radiography, CT, and ileocolonoscopy were used. Abstract

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Practice Parameters for the Surgical Management of Crohn's Disease

Cited by 42 publications

References 145 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

Evidence-based clinical practice guidelines for Crohn’s disease, integrated with formal consensus of experts in Japan

Crohn’s Disease Presenting as Acute Appendicitis, Case Series

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