Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010346 (Crohn's disease)
 21,615 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 40 years old female patient presenting with symptoms of acute intestinal obstruction was diagnosed as a case of adenocarcinoma superimposed on Crohn's disease. The diagnosis, as happens in most of these cases, was established post-operatively on the basis of histopathological examination. Acute intestinal obstruction due to adenocarcinoma in Crohn's disease as an initial presentation is very uncommon especially in this geographical area where Crohn's disease in itself is an uncommon disease entity.
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PMID:Acute intestinal obstruction as an initial presentation in Crohn's carcinoma. 322 24

The collagen content and the relative amount of collagen types were quantitated in control intestine as well as in both inflamed and strictured intestine resected from patients with Crohn's disease. The major collagen type in control intestine was type I (68%), followed by types III (20%) and V (12%). In strictured intestine both collagen content and the relative amount of type V collagen were significantly increased compared with control intestine. Histologic studies demonstrated that in strictured specimens there was a striking proliferation of smooth muscle cells of the muscularis mucosae associated with an accumulation of collagen in the submucosa. The thickness of the muscularis propria was also increased. Immunohistochemical studies demonstrated small amounts of type V collagen in the submucosa of control bowel. In contrast, large amounts of type V collagen were seen in the fibrotic, expanded submucosa of strictured bowel, particularly in the areas where smooth muscle cells of the muscularis mucosae had proliferated. Intestinal strictures in Crohn's disease are therefore characterized by an accumulation of collagen, a proliferation of smooth muscle cells, and an increase in type V collagen, a collagen type produced in relatively large amounts by smooth muscle cells. These changes appear to result in both a loss of the normal compliance of the intestine and a thickening of the intestine wall, resulting ultimately in the intestinal obstruction so frequently seen in patients with Crohn's disease.
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PMID:Collagen content and types in the intestinal strictures of Crohn's disease. 333 5

A retrospective review was undertaken to determine factors important in predicting functional results following the ileal reservoir and ileoanal anastomosis procedure. One hundred seventy-nine patients underwent ileal reservoir and ileoanal anastomosis at the University of Toronto between December 1981 and January 1987. One hundred sixty-three patients had ulcerative colitis, 11 had familial adenomatous polyposis, and five had Crohn's disease. A J-reservoir was constructed in 72 patients and an S-reservoir in 107 patients. Functional results were assessed in 102 patients who had their loop ileostomies closed for more than one year. The most significant technical complications were anal anastomotic leaks (10 percent), reservoir anastomotic leaks (3.9 percent), anal anastomotic stricture (7.8 percent), late fistula-inano (2.8 percent), small-bowel obstruction (19 percent), and loop ileostomy complications (23 percent). Overweight males and patients with operative blood loss greater than 1000 cc developed anal stricture more frequently (P less than .005). Patients who had a stapled J-reservoir had a higher rate of reservoir leak. The average number of bowel movements reported by patients for 24 hours was 6.2 +/- 3.1. Only ten (9.8 percent) patients had to intubate their reservoir to empty it. Urgency was experienced by 24 patients and soilage at night by 23 (22.5 percent) and during the day by 18 (17.6 percent). Seven patients (6.8 percent) were incontinent during the night and only one during the day. Pouchitis was reported in 16 patients (15.7 percent). Patients with anal anastomotic stricture had more urgency and pouchitis, and had to intubate their reservoir more frequently (P less than .05). No other factors analyzed affected technical or functional results.
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PMID:The ileal reservoir and ileoanal anastomosis procedure. Factors affecting technical and functional outcome. 336 21

A survey questionnaire was sent to 125 radiology programs to determine the frequency and indications for the use of small bowel enteroclysis. Sixty-seven of the 84 respondents perform small bowel enteroclysis while 17 do not. The 3 most common indications for enteroclysis are detection of unexplained gastrointestinal bleeding, partial small bowel obstruction, and Crohn's disease. We conclude that although small bowel enteroclysis is a well-established examination, there are wide differences in the frequency with which it is performed, the techniques of examination, and indications for its use.
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PMID:Small bowel enteroclysis survey. 338 63

Although dilatation of the jejunum is a well-recognized feature of Crohn's disease there has been no systematic inquiry as to whether this is related simply to distal intestinal obstruction or to other factors such as hypoalbuminemia and mucosal disease. Barium follow-up examinations of 21 patients with Crohn's disease who had serum albumin concentrations of 2.1-4.4 g/dl were reviewed. Fourteen of these patients (67%) had increased mean jejunal width. All patients with direct radiologic evidence of a stricture (six patients) had increased jejunal caliber, but this only accounted for 43% of patients with this abnormality. Of the remaining eight patients, six had hypoalbuminemia, three of whom had serum albumin concentrations less than or around 2.7 g/dl, the previously determined "albumin threshold" for jejunal dilatation. We conclude that increased jejunal caliber in Crohn's disease not only occurs in association with distal intestinal stenosis but also with severe hypoalbuminemia in the absence of obstruction. We were unable to define a cause of jejunal dilatation in 36% of these patients, but propose that functional obstruction due to distal nonstenosing inflammatory disease may be a factor.
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PMID:Jejunal dilatation in Crohn's disease. Intestinal obstruction or intestinal edema? 341 92

Forty patients with an ultrasonically evaluated appendiceal mass were studied. Abscesses were diagnosed in 31 patients (78%). Seventeen patients had an ultrasonically guided percutaneous drainage performed, and all but one patient had resolution of symptoms without further treatment or complications. Fourteen patients were treated conservatively without drainage, and 12 had resolution of symptoms without interference. Ultrasonograms in the remaining nine patients (22%) revealed phlegmonous inflammation only, and all recovered without treatment. The three patients considered failures had surgery because of intestinal obstruction or suspected but unverified perforation. Three patients (8.5%) had recurrent appendicitis within 5 months after the initial attack. Diagnostic errors delayed proper therapy for 1 month in a patient with a cecal carcinoma and for 5 months in a patient with Crohn's disease. Late sequelae were observed in four patients, three of whom had surgery. Nonoperative treatment and if possible ultrasonically guided percutaneous drainage of verified abscesses are safe procedures with few complications and late sequelae. However, diligent in-hospital observation and close follow-up are mandatory.
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PMID:Nonoperative management of the ultrasonically evaluated appendiceal mass. 355 78

During seven years, 212 small bowel examinations are made on patients with suspected small bowel obstruction by barium infusion. We find all the main small bowel pathology: Crohn's disease (16.5%), carcinomatosis (14.6%), neoplasia (10.3%), vascular disease (17.8%), actinic enteritis (9.5%) and miscellanous (18%). The small bowel infusion is normal in 15%. Surgery is avoided in 51% of the cases. There is non complications associated with the examination but in 12% of the cases, the examination is unsuccessful.
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PMID:[Value of small intestine transit by enteroclysis in obstructive syndromes of the small intestine. Apropos of 212 examinations]. 356 27

Ninety-three patients with Crohn's disease who had not undergone bowel resection at the time of diagnosis (during the years 1969-1983) were selected for the study, to elucidate whether initial anatomical involvement correlates with clinical manifestations, complications, laboratory findings, and prognosis. Forty-one patients had isolated small intestine disease (44%), 37 ileocolic (40%), 13 colonic disease alone (14%), and two rectal or appendix involvement (2%). Statistically significant symptoms were fever and rectal bleeding with colon involvement, and number of liquid or very soft stools in 1 week with ileocolic or colon involvement. Statistically significant complications included intestinal obstruction with ileocolic disease, perianal fistulas, and arthritis with colonic disease. Increases in ESR, C-reactive protein, and white blood cell in patients with colon involvement were among the statistically significant laboratory findings. Gammaglobulin was significantly higher in patients with ileocolic or colon involvement than in those with small intestine disease. Red cell count and hemoglobin were significantly lower in patients with ileocolitis than in patients with small intestine involvement. Crohn's disease activity index (CDAI) was significantly higher in patients with ileocolic or colon involvement than in those with small intestine involvement only. These findings confirm that colonic involvement renders the disease more severe than involvement of the small intestine. Surgery was required for 22 patients (24%) during a 2.8-year follow-up, but the difference among the three groups was not significant.
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PMID:Anatomical involvement and clinical features in 91 Japanese patients with Crohn's disease. 357 91

The object of this study is to focus attention on the causes of intestinal obstruction in Libya. In this study, spread over 30 months and involving 114 patients, the most common cause was the entrapment of bowel in an external hernia. Postoperative adhesions accounted for obstruction in a third of our patients, and 59 per cent of them followed appendicectomy. Biliary lithiasis is the most common surgical disease in Libya, yet there was only one instance of gallstone ileus in this series. Sigmoid volvulus and intestinal lymphoma were also rare, and tubercular stricture and Crohn's disease were remarkable by their absence. There were no cases of idiopathic intussusception during or immediately following Ramadan.
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PMID:Major causes of intestinal obstruction in Libya. 358 Aug 11

Since the seventieth low molecular weight formulas, "elemental diets", are applied in acute Crohn's disease in addition to drug therapy. In small bowel involvement, therapeutic efficiency in active disease is as good as salazosulfapyridine combined with corticosteroids. Physiological changes under elemental diet have been reported: decrease of gastric and pancreatic secretion, changes of bacterial bowel flora and in patients with Crohn's disease decreased fecal bile acid excretion and decreased intestinal losses of lymphocytes were described. Further, the absence of allergens in the formula and the quick and complete resorption are discussed to be important to clinical improvement in Crohn's disease. Indications for elemental diet are acute small bowel disease, intestinal obstruction, malnourishment and growth retardation. Further studies are needed to examine if elemental diets are effective in gastrointestinal fistulas and extraintestinal symptoms in Crohn's disease.
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PMID:[Status of elemental diets in the therapy of Crohn disease in childhood]. 361 53


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