Indications and Outcome of Surgical Treatment of Crohn’s Disease in Gastroenterology and Hepatology Hospital
DOI:
https://doi.org/10.54536/ajmsi.v4i1.4347Keywords:
Acute Appendicitis, Crohn’s Disease, Intestinal Obstruction, Ileocecal Resection, Liver ResectionAbstract
Crohn’s disease of both varieties (abdominal and perineal) may lead to many surgical complications treated by different procedures. The role of surgery has a paramount importance in treating Crohn’s disease complications despite medical therapy. The purpose of this study is to investigate the indications, types, and outcomes of surgical therapy for Crohn’s disease at gastroenterology and hepatology hospitals. This is a longitudinal sectional prospective study that was conducted in Gastroenterology and Hepatology Hospital from March 2020- May 2022, involves 35 patients of Crohn’s disease were diagnosed relying on clinical, radiological, and histopathological result based on endoscopic biopsy and/or surgical specimen. Current study demonstrated that the most common indication of surgery in abdominal Crohn’s disease cohort is intestinal obstruction with 23 patients (65.71%) treated by ileocecal resection. Intestinal fistula 7 patients (20%). Failure of medical treatment 3 patients (8.57%). Malignancy 2 patients (5.71%). Psoas abscess drainage 1 patient (2.85%). Most common Indication of surgery in peri-anal Crohn’s disease is intractable perianal fistula to medical treatment 5 patients (14.28%), Perianal abscess patients (8.57%). Although the medical treatment is the corner stone in management of Crohn’s disease but early referral to digestive surgeon is preferable to decrease the suffering of the patients and improve the outcome.
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References
Abraham, C., & Cho, J. H. (2009). Inflammatory bowel disease. New England Journal of Medicine, 361(21), 2066-2078.
Atkinson, C., McQuillan, D. M., & Balfour, W. D. (2006). A child with fever, hip pain, and limp. Canadian Medical Association Journal, 174(7), 924.
Baumgart, D. C., & Sandborn, W. J. (2007). Inflammatory bowel disease: Clinical aspects and established and evolving therapies. The Lancet, 369(9573), 1641-1657.
BBeck, D. E., Herfarth, H. H., & Williams, J. T. (2014). Outcome of surgical treatment for Crohn’s disease. Diseases of the Colon & Rectum, 57(6), 758-764.
Bednarz, W., Szymczak, A., & Kaczmarek, A. (2008). Analysis of results of surgical treatment in Crohn’s disease. Hepatogastroenterology, 55(84), 998-1001.
Broe, P. J., Bayless, T. M., & Cameron, J. L. (1982). Crohn’s disease: Are enteroenteral fistulas an indication for surgery? Surgery, 91(3), 249-253.
Crohn, B. B., Ginzburg, L., & Oppenheimer, G. D. (2000). Regional ileitis: A pathologic and clinical entity. Mount Sinai Journal of Medicine, 67(3), 263-268. (Original work published 1932)
Farmer, R. G., Hawk, W. A., & Turnbull, R. B., Jr. (1975). Clinical patterns in Crohn’s disease: A statistical study of 615 cases. Gastroenterology, 68(4 Pt 1), 627-635.
Frolkis, A. D., Dykeman, J., Negrón, M. E., et al. (2013). Risk of surgery for inflammatory bowel diseases has decreased over time: A systematic review and meta-analysis of population-based studies. Gastroenterology, 145(5), 996-1006.
Greenstein, A. J., Sachar, D. B., & Moser, S. E. (1987). Spontaneous free perforation and perforated abscess in 30 patients with Crohn’s disease. Annals of Surgery, 205(1), 72-76.
Haddad, M., Lataire, J., & De Bie, W. (1993). Crohn’s disease of the appendix. European Journal of Surgery, 159(3), 191-192.
Jess, T., Frøslev, T., & Nielsen, D. K. (2006). Survival and cause-specific mortality in patients with inflammatory bowel disease: A long-term outcome study in Olmsted County, Minnesota, 1940-2004. Gut, 55(9), 1248-1254.
Kühn, F., Nixdorf, M., & Klar, E. (2015). The role of surgery in Crohn’s disease: Single-center experience from 2005-2014. Gastroenterology, 148(Suppl 1), S-1167.
Mazal, J. (2014). Crohn disease: Pathophysiology, diagnosis, and treatment. Radiologic Technology, 85(3), 297-316; quiz 317-320.
McNamara, M. J., Inoue, S., & Kuo, J. T. (1990). Surgical treatment of enterovesical fistulas in Crohn’s disease. Diseases of the Colon & Rectum, 33(4), 271-276.
Michelassi, F., Voudouris, J. M., & Maggiore, G. (1993). Incidence, diagnosis, and treatment of enteric and colorectal fistulae in patients with Crohn’s disease. Annals of Surgery, 218(5), 660-666.
Munkholm, P., Pedersen, N., & Rasmussen, H. (1994). Frequency of glucocorticoid resistance and dependency in Crohn’s disease. Gut, 35(3), 360-362.
Mühe, E., Sommer, R., & Möller, K. (1981). Surgery of Crohn’s disease: A study of 155 patients after intestinal resection (author’s transl). Deutsche Medizinische Wochenschrift, 106(6), 165-170.
Nasseri-Moghaddam, S. (2012). Inflammatory bowel disease. Middle East Journal of Digestive Diseases, 4, 77-89.
Prieto-Nieto, I., García-Arranz, M., & García-Sánchez, S. (2001). Crohn’s disease limited to the appendix. American Journal of Surgery, 182(5), 531-533.
Rodriguez, T., & Kwon, D. (2020). P314 C-Reactive protein is associated with depression and anxiety in patients with inflammatory bowel disease. Journal of Crohn’s and Colitis, 14(Suppl 1), S311.
Rastogi, V., Saxena, M., & Juyal, R. (2018). Abdominal physical signs and medical eponyms: Movements and compression. Clinical Medicine & Research, 16(3-4), 76-82.
Shaffer, V. O., & Wexner, S. D. (2013). Surgical management of Crohn’s disease. Langenbeck’s Archives of Surgery, 398(1), 13-27.
Stangl, P. C., Selby, D. J., & Christensen, R. D. (2002). Crohn’s disease of the appendix. Virchows Archiv, 440(4), 397-403.
Tekkis, P. P., Heriot, A. G., & Thompson, M. R. (2006). A comparison of segmental vs subtotal/total colectomy for colonic Crohn’s disease: A meta-analysis. Colorectal Disease, 8(2), 82-90.
Tzivanakis, A., et al. (2012). Influence of risk factors on the safety of ileocolic anastomosis in Crohn’s disease surgery. Diseases of the Colon & Rectum, 55(5), 558-562.
Van Koperen, P. J., Bemelman, W. A., & Cuesta, M. A. (2009). Outcome of surgical treatment for fistula in ano in Crohn’s disease. British Journal of Surgery, 96(6), 675-679.
Vanek, V. W., Vargo, G., & Lopatka, D. (1988). Isolated Crohn’s disease of the appendix: Two case reports and a review of the literature. Archives of Surgery, 123(1), 85-87.
Zhang, W., et al. (2014). The respective role of medical and surgical therapy for enterovesical fistula in Crohn’s disease. Journal of Clinical Gastroenterology, 48(8), 708-711.
Zohar, M. (2013). Inflammatory bowel disease. New England Journal of Medicine, 361(21), 2066-2078.
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