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Query: UMLS:C0010346 (
Crohn's disease
)
21,615
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The case of a 14-year-old boy who had oral ulcers with histologic proof of granulomatous disease nine months before the diagnosis of intestinal
Crohn's disease
is presented. Additional extraintestinal manifestations of this case were cheilitis, anal fissures, and "metastatic" disease to the umbilicus. The diagnosis was established after the onset of abdominal symptoms. All manifestations responded rapidly to systemic prednisone, sulfasalazine, and metronidazole.
Dis Colon
Rectum
1988 Jul
PMID:Oral inflammatory changes as an initial manifestation of Crohn's disease antedating abdominal diagnosis. Report of a case. 339 Oct 63
The expression of gastrointestinal cancer antigen, CA 19-9, and of carcinoma-associated antigen, CA-50, was studied in formalin-fixed and paraffin-embedded tissue from 18 patients with ulcerative colitis, 29 with
Crohn's disease
in the colon, four with diverticular disease, and eight with sigmoid volvulus. None of the patients with inflammatory bowel disease showed strong dysplasia or had manifest carcinoma. Both antigens were expressed frequently in patients with inflammatory bowel disease. Of the 18 patients with ulcerative colitis, 17 were positive for both CA 19-9 and CA-50, and of the 29 with Crohn's colitis, 21 were positive for CA 19-9 and 22 for CA-50. No distinct differences in antigenic expression were found between
Crohn's disease
and ulcerative colitis. CA-50 was expressed in normal colonic mucosa from 10 of 12 patients with sigmoid volvulus or diverticular disease, and such mucosa was positive for CA 19-9 in three of the four patients with diverticular disease and in two of the eight patients with sigmoid volvulus. It is concluded that immunodetection of CA-50 or CA 19-9 is of limited value in the differential diagnosis of inflammatory bowel disease. The usefulness of these antigens as markers for precancerous changes in inflammatory bowel disease is also doubtful, since the expression is also frequent in cases of inflammatory lesions, with no obviously increased risk of malignancy.
Dis Colon
Rectum
1987 Jul
PMID:Expression of the carcinoma-associated antigens CA 19-9 and CA-50 in inflammatory bowel disease. 347 29
A 23-year-old man with cystic fibrosis developed massive rectal bleeding that continued intermittently, necessitating an emergency laparotomy and total colectomy. The resected colon was shortened by fibrosis and displayed widespread excessive production of mucus, forming a carpetlike layer over the mucosa as well as segmental discrete areas of mucosal ulceration with fissures, transmural inflammation, and multiple epithelioid granulomas, which are in keeping with
Crohn's disease
. One case, in a seven-year-old girl, had been reported previously.
Dis Colon
Rectum
1986 Sep
PMID:Cystic fibrosis, Crohn's colitis, and adult meconium ileus equivalent. 348 86
The finding that splenic atrophy is associated with a high complication rate in colitis has led to a long-term, prospective study of spleen size in inflammatory bowel disease. The spleen has been measured in 116 patients undergoing laparotomy for inflammatory bowel disease--80
Crohn's disease
and 36 ulcerative colitis--from 1975 to 1985. Small spleen size, of lesser degree than that of classic splenic atrophy, is associated with presurgery disease complications as well as infective problems after surgery. Spleen size was not related to site or extent of disease, or to recurrence, but the wide range of spleen size seen in inflammatory bowel disease, comparable to that seen in malignancy suggests that more sophisticated tests of splenic function might show a closer correlation with disease patterns.
Dis Colon
Rectum
1987 Jun
PMID:Spleen size in patients with inflammatory bowel disease. Does it have any clinical significance? 359 56
In this study the Multi-Test was applied in 48 patients with inflammatory bowel disease and in 25 normal controls. A significant difference between normal controls and patients with
Crohn's disease
but not between normal controls and patients with ulcerative colitis was found with regard to anergic status, frequency of positive skin reactions, and size of skin infiltration. The authors conclude that in patients with
Crohn's disease
a defect exists in the cellular immunity.
Dis Colon
Rectum
1987 Jul
PMID:Cutaneous delayed hypersensitivity in Crohn's disease and ulcerative colitis. Application of multi-test. 359 75
Samples of maximally diseased and adjacent macroscopically normal intestine from 52 patients undergoing surgery for
Crohn's disease
were analyzed for ascorbate content; 26 of the patients had intestinal fistulas and 26 did not. Ascorbate analyses were also performed on samples of normal intestine from ten control patients. Diseased intestine from both groups of patients with
Crohn's disease
contained significantly more ascorbate than the adjacent macroscopically normal intestine. Their diseased intestine also contained significantly more ascorbate than normal intestine from controls. Whereas diseased intestine from patients without fistulas contained 47 percent more ascorbate than their normal intestine (P less than .001), the diseased intestine from patients with fistulas contained only 23 percent more ascorbate than their normal intestine (P less than .02). Patients with fistulas appear unable to concentrate as much ascorbate in their diseased intestine as patients without fistulas. This difference may be a factor in the pathogenesis of fistula formation in
Crohn's disease
because of the importance of ascorbate in collagen production.
Dis Colon
Rectum
1987 Jul
PMID:Does local intestinal ascorbate deficiency predispose to fistula formation in Crohn's disease. 359 77
Localized giant pseudopolyposis of the colon is a rare complication of both ulcerative colitis and
Crohn's disease
. It is not regarded as being premalignant, but it may masquerade clinically as a malignancy. This report presents a case and reviews others reported in the literature.
Dis Colon
Rectum
1987 Oct
PMID:Localized giant pseudopolyposis of the colon in ulcerative colitis. Report of a case. 365 93
The clinical course of
Crohn's disease
in 131 patients was studied for a mean period of 4.2 +/- 3.2 years. The clinical activity of the disease, expressed as percentage of patients per year in an active phase, is high in the first year (70.2 percent) and progressively decreases during subsequent years (25 percent after seven years). The percentage of patients who needed steroid treatment is high during the first year (68 percent) and falls to 19 percent after seven years. An operative risk rate of 54 percent was registered, with a probability of reoperation equal to 34 percent. Clinical relapse after the first surgery occurred in 70 percent of cases. The registered mortality was 6.9 percent, with a ratio of 6 to 1 between observed and expected mortality. In conclusion, the disease, while showing a tendency to reduce its activity over the years, is burdened by a risk of surgery and mortality which progressively increases with time.
Dis Colon
Rectum
1987 Nov
PMID:Clinical course of Crohn's disease in Italy. 367 64
Between 1981 and 1986, transanal rectal advancement flaps were employed in the surgical management of 39 anorectal fistulas at the Cleveland Clinic. Included were 23 low rectovaginal, 12 fistulas-in-ano and, four rectourethral fistulas. Nineteen fistulas occurred in patients with
Crohn's disease
while the other 20 included 11 due to obstetric or surgical injury. This technique has become the Clinic's standard management for low rectovaginal fistulas but is reserved for complex fistulas-in-ano. Active proctitis or malignancy are contraindications to the procedure. Surgery requires elevation of a broad-based rectal flap, curettage of the tract, and advancement and primary suture of the flap over the internal opening. Fistulas were eradicated in 27 cases (69.2 percent) including 11 of 19 due to
Crohn's disease
(57.9 percent) and 16 of the 20 (80.0 percent) from other causes (mean follow-up, 25 months). Rectovaginal fistulas healed in 60.0 percent of those with
Crohn's disease
compared with 76.9 percent of those due to other causes. Complex fistulas-in-ano in
Crohn's disease
did less well. Only two of six of these fistulas healed. Temporary stomal diversion was used on nine occasions and a successful outcome was achieved in only four, indicative of the greater complexity of these cases. It is concluded that the transanal rectal advancement flap can be an effective method of repair for fistulas of the anorectal region including selected cases due to
Crohn's disease
.
Dis Colon
Rectum
1987 Dec
PMID:The use of transanal rectal advancement flaps in the management of fistulas involving the anorectum. 369 Dec 61
Seven patients with widespread, active, stricturing, small intestinal
Crohn's disease
and two with localized disease were treated by a total of 45 strictureplasties. They have been followed up for a mean of 20 months (range 6 to 30). Two patients had early postoperative complications with enterocutaneous fistulas, one of which may have been related to a strictureplasty. The two patients with localized disease remain well after 16 and 30 months. Of the seven patients with extensive small bowel disease, two are well six and 28 months after surgery. Recurrent symptoms developed in six patients two to six months postoperatively; four of those patients required further surgery. Previous reports of strictureplasty in inactive
Crohn's
strictures suggest it is a safe operation with good long-term results. Strictureplasty in active
Crohn's disease
has a much higher recurrence rate of symptoms. Because it is a conservative operation, however, we believe it has a place in the surgical treatment of
Crohn's disease
.
Dis Colon
Rectum
1986 May
PMID:Strictureplasty. A good operation for small bowel Crohn's disease? 369 54
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