The dilemma of Crohn's disease

Fazio, Victor W.; Wilk, Peter J.; Turnbull, Rupert B.; Jagelman, David G.

doi:10.1007/bf02587365

Cited by 65 publications

(5 citation statements)

References 5 publications

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“…In an earlier report from our institution, sigmoid resection was used almost exclusively. 4 A primary criticism of this group of patients was that a substantial number were malnourished and a covering stoma was often created. Several other authors have advocated primary repair of the sigmoid colon and have reported satisfactory results after primary repair of the sigmoid colon.…”

Section: Discussionmentioning

confidence: 99%

“…1 Overall, fistulas between diseased terminal ileum and the sigmoid colon represent 15% to 30% of patients with internal fistulas 1,2 and approximately 5% of all patients presenting with Crohn's disease. 2,3 While ileosigmoid fistulas (ISF) in CD are relatively common and surgery is considered to be the mainstay of treatment, historically, their management has been challenging 4,5 with only few recent reports characterizing contemporary outcomes. 6,7 The complexity of ISF in CD is in no small part because ISF often occurs in conjunction with more extensive disease including additional small bowel or colonic locations, fistulization to bladder or other bowel segments, or enterocutaneous fistula.…”

Section: Introductionmentioning

confidence: 99%

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Contemporary Surgical Management for Ileosigmoid Fistulas in Crohn’s Disease

Melton

Stocchi

Wick

et al. 2009

Journal of Gastrointestinal Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Contemporary Surgical Management for Ileosigmoid Fistulas in Crohn’s Disease

Melton

Stocchi

Wick

et al. 2009

Journal of Gastrointestinal Surgery

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“…Some investigators advocate ileal resection with primary anastomosis and fistula repair, and some advocate ileal resection with primary anastomosis and rectosigmoid resection with primary anastomosis [10, 11, 12]. Occasionally, a temporary diversion of the fecal stream from the rectosigmoid colon closure may be necessary because of local inflammation or abscess [6, 7].…”

Section: Discussionmentioning

confidence: 99%

Management of Fistulas in Crohn’s Disease

Ikeuchi

Shoji²,

Yamamura³

2002

Dig Surg

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Aim: This study was conducted to clarify operative indications, surgical treatment, and postoperative complications of intra-abdominal fistulas in Crohn’s disease. Methods: Of 213 patients undergoing surgical treatment for Crohn’s disease in our institution between 1972 and 2000, 55 patients (25.8%) found to have 81 intra-abdominal fistulas were retrospectively reviewed. Results: The most common indication for surgery was intestinal obstruction. A fistula represented a single indication for surgical treatment in 9 operations (15.5%). All patients with intra-abdominal fistulas underwent resection of the diseased intestinal segment. Closure of the fistulous defect of the affected lesion was achieved by suture (n = 27), stapled fistulectomy (n = 12), or resection (n = 11). Resection of the diseased bowel was achieved by en bloc removal of the fistula in 15 cases. When the fistula opened through the abdominal wall (n = 12), the diseased portion of the intestine was resected, and the fistulous tract was debrided. Only 1 patient died postoperatively from multiple organ failure because of anastomotic breakdown. Conclusions: The surgical treatment of an intra-abdominal fistula in Crohn’s disease is based on resection of the diseased intestinal segments, and the affected lesion can be sutured. This procedure can be achieved safely, and the incidence of postoperative complications is low.

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“… 7 The most commonly affected areas are the ileocecal area, terminal ileum, and the small bowel. 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

“…7 The most commonly affected areas are the ileocecal area, terminal ileum, and the small bowel. 8,9 The symptoms of IBD are not limited to gastrointestinal symptoms but are usually associated with extraintestinal manifestations related to intestinal disease activities. [10][11][12] Moreover, abdominal pain, abdominal bloating, fever, weight loss, fatigue, persistent diarrhoea, and the presence of blood and mucus in the stool can also occur.…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Review of Ustekinumab Utilization in Inflammatory Bowel Diseases: Insights from the ClinicalTrials.gov Registry

Alorfi,

Alourfi,

Bokhari

et al. 2023

IJGM

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Background Inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis, are chronic inflammatory conditions affecting the gastrointestinal tract. To achieve and sustain remission, effective treatment strategies are necessary. Ustekinumab, a biologic agent targeting interleukin-12 and interleukin-23, has emerged as a significant therapeutic option for moderate to severe IBD. Aim To gain insights into the utilization of Ustekinumab for IBD, we conducted a comprehensive review of the ClinicalTrials.gov registry. Methods A comprehensive search of the ClinicalTrials.gov was conducted to find all clinical trials involving the use of Ustekinumab in IBD patients. As of December 30th, 2022, 69 clinical trials were identified that included IBD and Ustekinumab. The study list was saved, and those clinical trials that fitted the definition of targeted therapy were included in the review. Results The results showed that Ustekinumab was associated with significant improvements in the clinical response and remission rates, in both Crohn’s disease and ulcerative colitis patients. Additionally, the safety profile of Ustekinumab was generally favourable, with low rates of adverse events reported. In terms of study design, most of the relevant studies found in the database were interventional studies. The investigation focused on completed studies and found that there were a limited number of clinical trials with interventional measures. Conclusion Ustekinumab appears to be a promising treatment option for patients with IBD, with the potential to provide significant clinical benefits and a favourable safety profile. Further research is warranted to confirm these findings and explore optimal dosing and treatment regimens.

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The dilemma of Crohn's disease

Cited by 65 publications

References 5 publications

Contemporary Surgical Management for Ileosigmoid Fistulas in Crohn’s Disease

Contemporary Surgical Management for Ileosigmoid Fistulas in Crohn’s Disease

Management of Fistulas in Crohn’s Disease

Comprehensive Review of Ustekinumab Utilization in Inflammatory Bowel Diseases: Insights from the ClinicalTrials.gov Registry

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