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[Surgical therapy of Crohn disease and ulcerative colitis in childhood]
A Würfel1, K L Waag, S Hofmann-von Kap-herr
1Kinderchirurgische Universitätsklinik Mainz, Bundesrepublik Deutschland.
Insights
Surgery for pediatric Crohn's disease often addresses complications like strictures and fistulas. Crucially, surgical intervention can reverse growth and developmental delays in children with Crohn's disease, restoring normal development.
Area of Science:
- Pediatric surgery
- Gastroenterology
- Pediatric inflammatory bowel disease (IBD)
Context:
- Crohn's disease (CD) and ulcerative colitis (UC) are major forms of pediatric inflammatory bowel disease (IBD).
- Surgical interventions in pediatric IBD primarily address complications such as stenoses, abscesses, and fistulae.
- Growth and developmental impairment are significant concerns in children with CD.
Purpose:
- To evaluate the role and outcomes of surgical interventions in children with Crohn's disease (CD) and ulcerative colitis (UC).
- To assess the impact of surgery on growth and development in pediatric CD patients.
- To outline surgical indications and procedures for pediatric IBD.
Summary:
- Surgical procedures for pediatric Crohn's disease (CD) commonly involve repairing stenoses, abscesses, and fistulae.
- Surgery is vital for preventing irreversible impairment in children experiencing growth and developmental retardation due to CD.
- In a cohort of 32 patients, 17 showed significant pre-operative retardation; 13 achieved normal growth post-surgery.
- Surgical indications and procedures for pediatric ulcerative colitis (UC) are similar to those in adults, though surgery is less frequently required.
Impact:
- Surgical intervention can significantly improve growth and development in pediatric patients with Crohn's disease.
- Early surgical management can prevent long-term developmental deficits in children with severe CD.
- Findings support the use of surgery to manage complications and growth issues in pediatric IBD.
Abstract:
Surgery in children with Crohn's disease--like in adults--most frequently consists in the repair of stenoses, abscesses and fistulae. However, if growth and development are retarded, surgery must also be used to prevent irreversible impairment. Seventeen (of 32) patients were considerably retarded before surgery; 13 of these recovered to normal after operation. As regards ulcerative colitis, surgery is rarely needed in children, but if so, the indication and procedure is the same as for adults.