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Query: UMLS:C0010346 (Crohn's disease)
 21,615 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fibrotic strictures of the small bowel are known to cause chronic bowel obstruction in patients with Crohn's disease. Strictureplasty without resection permits relief of bowel obstruction and preservation of bowel length. The records of 13 patients who underwent 52 strictureplasties for Crohn's disease at the Lahey Clinic Medical Center, Burlington, Mass, from 1982 through 1989 were reviewed to determine the results of this surgical intervention. Nine patients were treated with strictureplasty only, while the remaining 4 patients underwent concomitant small-bowel resection for stenosed areas not amendable to strictureplasty. One early complication occurred in a patient in whom a pelvic abscess developed. In a median follow-up period of 2 years (range, 0.5 to 7 years), 9 patients were rehospitalized because of obstruction from Crohn's enteritis. Four patients required further surgery, 3 patients underwent strictureplasty at a newly stenosed area of small bowel, and 1 patient required resection of the initial strictureplasty. Strictureplasty is an effective surgical option for patients with Crohn's disease who have symptomatic small-bowel strictures.
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PMID:Strictureplasty of the small bowel in patients with Crohn's disease. An effective surgical option. 234 73

Eight patients with cystic fibrosis had chronic abdominal pain and the other features of distal intestinal obstruction syndrome. Coexistent abdominal pathology was shown in six patients. Two had a small bowel volvulus, and the others had Crohn's disease, a small bowel fistula, appendix abscess, and an ovarian dermoid. Opiate abuse exacerbated symptoms in two other patients.
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PMID:Pathology mimicking distal intestinal obstruction syndrome in cystic fibrosis. 235 96

In 1974 total colectomy and ileoanal straight endorectal pull-through (ERPT) were first used at our institution for the definitive management of total colonic Hirschsprung's disease in infants and children. Early success with this operation encouraged us to use this procedure in children and adults with ulcerative colitis and familial polyposis in 1977. Since 1974 we have performed total colectomy and straight ileoanal ERPT on 100 consecutive patients with ulcerative colitis (79), familial polyposis (19), and total colonic Hirschsprung's disease (10). Patients who have undergone a colectomy and ERPT but have not had their temporary ileostomy closed have been excluded from this report. This group of patients represents the only large series of straight ERPTs available for comparison with the various reservoir modifications that have been reported. All operations were performed under the direction of the author. The mean age at surgery was 20.6 +/- 9.8 years, with a range of 1 to 48 years. Forty-six patients were younger than 18 years at the time of operation. All patients with ulcerative colitis and familial polyposis underwent a temporary loop ileostomy with total abdominal colectomy with ERPT; the 10 infants and children with Hirschsprung's disease underwent the total colectomy and ERPT without a back-up ileostomy. There were two deaths in this series, one from fulminate hepatic failure in the late postoperative period and the other from multiple bowel fistulas and sepsis in a teenager with Crohn's disease, in whom the initial diagnosis was ulcerative colitis. Follow-up has ranged from 3 months to 15 years. There were 13 cases of adhesive bowel obstruction, seven of which required an enterolysis. Pelvic sepsis occurred in three patients, two of whom required operative drainage. Two women developed rectovaginal fistulas, which healed with temporary diversion. Minor wound infections occurred in five patients. There were no anastomotic leaks, nor were any cases of pouchitis encountered. In five patients permanent conversion to a Brooke ileostomy was required. Mean stool frequency 3 years after surgery was 7.7 per 24 hours. Daytime continence was achieved in all patients. Occasional nocturnal soiling occurred in 11.1% of patients at 1 year and was absent by 3 years. Neither age nor diagnosis (ulcerative colitis versus familial polyposis) affected stool frequency.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:A personal experience with 100 consecutive total colectomies and straight ileoanal endorectal pull-throughs for benign disease of the colon and rectum in children and adults. 239 80

In the English literature, only 27 cases of arterial thrombosis associated with Crohn's disease have been described. The present case appears to be the first reported case in the Japanese literature. A 43-year-old man was treated for intestinal obstruction caused by Crohn's disease and complicated by superior mesenteric vein thrombosis by surgical resection of 150cm of small bowel in June 1981. In March 1983, the right external iliac artery had become occluded and part of the left external iliac artery had assumed an irregular shape and the right ilio-femoral bypass surgery using PTFE was carried out. Three months later occlusive ileus reoccurred and angiograms showed that the superior mesenteric and right hepatic arteries had 30% and 20% stenosis respectively. Small bowel in 50cm in length was resected with subsequent administration of salicylazosulfapyridine at a dose of 3g per day. There was no reappearance of bowel symptoms. The patient again complained of numbness in the right leg in February 1988 and a left external iliac-right common femoral crossover bypass operation was carried out using a ringed 8mm Dacron graft. Intraoperatively, it was found that the left external iliac and the right common femoral arteries had intimal thickening but no atherosclerosis.
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PMID:[Arterial thrombosis associated with Crohn's disease: a case report]. 239 69

For the obstructed high-risk Crohn's disease patient, there is increasing evidence that timely surgery of a conservative nature can be performed with good effect. This article deals with the author's views, experience, and bias relating to the procedure of strictureplasty--the "emerging" conservative operation for the high-risk Crohn's patient with chronic bowel obstruction.
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PMID:Conservative surgery for Crohn's disease of the small bowel: the role of strictureplasty. 240 74

It is clear that the nutritional state of patients with inflammatory bowel disease is often impaired and that the provision of nutritional support results in an improvement in nutritional state of these patients. Improvement in nutritional status can be achieved as effectively with enteral as with parenteral nutrition. The nutritional support appears to have no primary therapeutic effect in patients with ulcerative colitis. With regard to nutritional support in Crohn's disease, parenteral nutrition should be restricted to use as supportive rather than primary therapy. Available information now seems to suggest that most of the benefits of parenteral nutrition in Crohn's disease are related to improvement in nutritional state rather than as primary therapy, and its use should be restricted to treatments of specific complications of Crohn's disease, such as intestinal obstruction, related to stricture formation or short bowel syndrome following repeated resection. The present available evidence indicates that defined elemental diets may have a primary therapeutic role in the management of first acute attacks of Crohn's disease when there is a need to improve the nutritional status of patients with inflammatory bowel disease as an adjunct to primary drug therapy. Enteral nutrition is as efficacious as parenteral nutrition; moreover, it is safer to administer and more cost-effective.
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PMID:Inflammatory bowel disease: nutritional implications and treatment. 251 42

A 48 years old male patient was admitted in the Risquez Hospital of Caracas, Venezuela presenting intestinal obstruction. An exploratory laparotomy was performed and two stenotic lesions in the small intestine were found. One of them in the proximal jejunum and the other in distal ileum. Both were resected and terminal jejunum-jejunum anastomosis and terminal jejunum-ileum anastomosis were performed. Pathological diagnosis was Crohn's Disease. Post operative evolution was satisfactory and four years after the patient is well.
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PMID:[Crohn's disease]. 253 63

Primary tumors of the small bowel are relatively rare. The 24 cases reported in this paper have been confirmed by operation and pathology. Based on clinical and radiologic findings and review of literature, the main X-ray manifestations of primary tumors of the small bowel were as follows: (1) Stenosis; (2) Filling defect; (3) Stiffness of involved intestinal wall with destruction of mucosa and loss of valvulae conniventes; (4) Intestinal obstruction or intussusception; (5) Dynamic dilatation and reversed peristalsis of the bowel segment proximal to the tumor. The causes of misdiagnosis and failure of detection and the site of predilection of the tumor were discussed. The differential points between benign and malignant tumors, sarcoma and carcinoma, metastatic tumor and primary tumor, Crohn's disease and carcinoma were mentioned.
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PMID:[X-ray diagnosis of primary tumors of the small bowel (report of 24 cases)]. 262 18

We have described an unusual case of Crohn's disease in a Meckel's diverticulum with both diverticulitis and intestinal obstruction in an elderly man.
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PMID:Crohn's disease of a Meckel's diverticulum causing diverticulitis and small bowel obstruction. 267 61

Epidemiological data indicate that exogenous noxes are important in the etiology of nonspecific inflammatory bowel disease. In several studies the influence of nutritional factors in the pathogenesis of Crohn's disease was investigated. The conflicting results, the inappropriate methods of investigation, the limited number of patients, and differences between patients and controls in many of these studies require a careful interpretation. Evidence for an etiological significance of nutrition in the development of Crohn's disease is still missing. Therefore, a specific diet for these patients does not exist. The physician should recommend a balanced diet which considers the needs in energy supply, corrects preexisting deficiencies, and is adapted to subjective intolerances and to disease related complications such as malabsorption or partial intestinal obstruction.
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PMID:[Nutrition and Crohn disease--an etiologic factor?]. 268 38


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