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Query: UMLS:C0021390 (inflammatory bowel disease)
 23,302 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The colonic mucosa produces a protective and lubricating layer of mucus. In certain conditions, the quantity and quality of this mucus is impaired. This study assessed the histochemical changes in mucus in inflammatory bowel disease compared with the severity and extent of the condition. Biopsy specimens were taken from 62 patients (32 with ulcerative colitis; ten with colonic Crohn's disease; ten with diverticular disease; ten with normal controls) and sections stained with high iron diamine-alcian blue to distinguish sulphated mucins from sialomucins. Normal subjects showed a predominance of sulphated mucins. The patients with Crohn's and diverticular disease also demonstrated this normal pattern. Of the 20 patients with ulcerative colitis, and without demonstrable dysplastic changes, only one showed a moderate increase in sialomucins. However, of the 12 patients with extensive colitis and dysplastic changes, ten had an increase in sialomucins. Thus, the predominant sialomucin pattern was seen mainly in patients with dysplasia. It may, therefore, indicate patients at high risk of malignancy.
Dis Colon Rectum 1986 Jan
PMID:A study of histochemical changes in mucus from patients with ulcerative colitis, Crohn's disease, and diverticular disease of the colon. 394 Jul 99

Hepatic portal venous gas occurring during an air-contrast barium-enema examination in patients with inflammatory bowel disease is a benign finding. Patients with chronic ulcerative colitis have experienced some morbidity, while those with Crohn's colitis have not. It may not be necessary to treat all of these patients with antibiotics, especially asymptomatic patients with Crohn's colitis.
Dis Colon Rectum 1986 Jan
PMID:Portal venous gas following a barium enema in a patient with Crohn's colitis. A benign finding. 394 Aug 6

A 62-year-old woman developed diffuse histiocytic lymphoma in the course of chronic lymphocytic leukemia and manifested symptoms mimicking chronic ulcerative colitis. Chronic lymphocytic leukemia may be complicated by the development of lymphoma designated Richter's syndrome. These lymphomas may present in the gastrointestinal tract with signs and symptoms suggestive of chronic inflammatory bowel disease. Initial diagnostic studies, especially barium studies, may yield similar findings. However, histologic findings and clinical course are particularly important in differentiating the disorders.
Dis Colon Rectum 1986 Mar
PMID:Richter's syndrome mimicking chronic colitis. A patient with diffuse histiocytic lymphoma complicating chronic lymphocytic leukemia. 394 35

A prospective study was undertaken to investigate the feasibility and diagnostic yield of ileoscopy as an extension of total colonoscopy. The distal 15 to 40 cm of the terminal ileum were visualized in 400 of 555 consecutive patients submitted to total colonoscopy (72 percent). Intubation of the terminal ileum was not successful in 42 patients (8 percent), not tried in 63 (11 percent), and hampered by inadequate colonic cleansing in 50 (9 percent). We observed 13 patients with terminal ileitis and seven rare findings such as nonspecific ileal ulcer or non-Meckelian diverticulum, etc., adding to a total of 20 pathologic findings in 400 examinations (5 percent). In a further group of 98 patients, useful diagnostic information was gained by the demonstration of normal ileal findings, making ileoscopy clinically valuable in 118 of 400 examinations (29.5 percent) in this series. We suggest routine endoscopy of the terminal ileum in all patients with suspected or established inflammatory bowel disease and/or persistent diarrhea, lower gastrointestinal tract bleeding, or irritable bowel syndrome, in whom the diagnostic procedure includes colonoscopy. In patients with colorectal tumors or polyps, the diagnostic yield will be unrewarding.
Dis Colon Rectum 1985 Jul
PMID:Endoscopy of the terminal ileum. Diagnostic yield in 400 consecutive examinations. 401 10

A computer analysis has been made of clinical experience of Crohn's disease in Australian patients. Between 1950 and 1978, 50 patients were managed for Crohn's disease by one of the authors (E.S.R.H.). This group represented 3.1 per cent of 1608 patients treated during the same period for primary inflammatory bowel disease. The mean follow-up period was 8.4 years. Thirty-nine of the 50 patients were female and 11 male. The small intestine was involved in seven patients, large intestine in 17 and both small and large intestine in 26. Symptoms were related to the anatomic localization of disease. Four patients have died (two postoperative deaths and two unrelated to Crohn's disease). Forty-nine of the 50 patients required operative procedures and 36 underwent one or more definitive operations with curative intention. A total of 124 operations was performed, 70 of which were definitive. Twenty-nine of the 36 patients managed by a definitive operation developed recurrence, defined to include reactivation of disease in intestinal segments left in situ. Ten patients developed two or more recurrences. Multiple recurrences were most frequent after operation for combined small- and large-intestinal Crohn's disease. No patient with large-intestinal Crohn's disease alone developed more than one recurrence. Each patient undergoing subtotal colectomy with ileorectal anastomosis (six patients) or ileostomy (nine patients) required one or more further definitive operations. Recurrence was more frequent after the first than second definitive operation (P = 0.007), the median recurrence-free intervals being 11 and 23 months, respectively.
Dis Colon Rectum 1980 Oct
PMID:Results of operative management of Crohn's disease: A series of 50 patients managed by one surgeon. 610 97

Experience in treating 100 patients with inflammatory bowel disease, for periods ranging from one to 15 years, is reviewed. A concise clinical classification of inflammatory bowel disease, correlated with a method of management, is presented. Relative rates of operation appear to be reduced over previously reported series: among chronic ulcerative colitis patients, 11 per cent had major precedures; for Crohn's disease, 36 per cent.
Dis Colon Rectum
PMID:Management of inflammatory bowel disease: an effective and concise approach. 624 9

The technique of intersphincteric excision of the rectum in patients with inflammatory bowel disease was introduced with the aim of avoiding postoperative sexual dysfunction and, combined with primary perineal suture, should decrease morbidity from delayed perineal wound healing. In a series of 98 patients so treated at St. Mark's Hospital, permanent sexual dysfunction from sympathetic nerve damage occurred in one male patient among 23 aged 60 years or less assessed postoperatively. No patient exhibited evidence of permanent parasympathetic nerve damage. Primary healing of the perineal wound was successful in 50 per cent of the cases and in 69 per cent the wound healed within three months of operation. It is suggested that this combination of operative techniques significantly decreases morbidity from rectal excision compared with more extensive procedures and should be more widely adopted.
Dis Colon Rectum 1984 Apr
PMID:Sexual function and perineal wound healing after intersphincteric excision of the rectum for inflammatory bowel disease. 637 Jun 32

The records of 15 patients whose surgical treatment involved the construction of a loop ileostomy were reviewed. Indications for loop ileostomy include the necessity to protect multiple or complicated anastomoses, the protection of ileorectal anastomoses in patients with inflammatory disease, and the necessity of diverting the flow of intestinal contents in patients with fulminant inflammatory bowel disease. The technique of constructing and taking down a loop ileostomy is described.
Dis Colon Rectum 1984 Jun
PMID:Loop ileostomy. Techniques and indications. 637 3

A retrospective study of 152 ileostomates with inflammatory bowel disease (IBD) revealed that 16 patients (10.5 per cent) had diagnoses of cholelithiasis before, at the time of, or after having ileostomies. Of the remaining patients, 69 were followed for possible cholelithiasis, most of those with sonographic examination. Sixteen of this latter group of patients (23.2 per cent) were found to have cholelithiasis, usually in an asymptomatic stage. Among women over 50 years old, seven of 11 (63.6 per cent) had gallstones. Due to this high prevalence of cholelithiasis, gallbladder imaging is recommended as a part of the preoperative workup and follow-up of ileostomates. Prophylactic cholecystectomy may be carefully considered in female patients with IBD at the time of proctocolectomy.
Dis Colon Rectum 1984 Sep
PMID:Cholelithiasis in ileostomy patients. 646 96

We report the results of a prospective audit of the rates of postoperative infection in patients having operations for inflammatory bowel disease. Apart from a single prospective controlled trial, all other groups have been studied sequentially using the original placebo control group for comparison. The rate of abdominal wound sepsis when no antibiotic was used was 37 per cent. This was reduced to 23.3 per cent with 24-hour cover using metronidazole and gentamicin. However, only after prolonged use of metronidazole and gentamicin for five days was there a significant reduction in abdominal wound infections to 13.3 per cent. Prophylaxis, using 24-hour cover with metronidazole combined with five-day therapy with mezlocillin, achieved an abdominal wound infection rate of 15.6 per cent. The most recent group of patients studied have received 24-hour cover with metronidazole and five-day exposure to latamoxef. In the last group the rate of abdominal wound infections was only 13.5 per cent and serious postoperative bleeding was recorded in eight patients (15 per cent) compared with serious bleeding is only three of the remaining 129 patients (2.3 per cent). The only patients in whom streptococcal isolates were eliminated were those receiving metronidazole and mezlocillin. The majority of infections was due to antibiotic-sensitive strains of Escherichia coli, Proteus, and Staphylococcus species.
Dis Colon Rectum 1984 Sep
PMID:Audit of sepsis in operations for inflammatory bowel disease. 646 1


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