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Related Concept Videos

Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
Inflammatory Bowel Disease I: Introduction01:26

Inflammatory Bowel Disease I: Introduction

Inflammatory bowel disease is a group of chronic disorders marked by recurrent inflammation of the gastrointestinal tract due to an abnormal immune response against gut microflora. This leads to tissue damage. The two main forms are Crohn’s disease and ulcerative colitis.Crohn’s DiseaseCrohn’s disease is a relapsing inflammatory disorder that can affect any part of the GI tract, from the mouth to the anus. It involves all layers of the bowel wall (transmural) and shows “skip lesions” in which...
Inflammatory Bowel Disease III: Crohn's Disease01:25

Inflammatory Bowel Disease III: Crohn's Disease

Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...
Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Inflammatory Bowel Disease IV: Clinical Manifestations01:20

Inflammatory Bowel Disease IV: Clinical Manifestations

Inflammatory bowel disease (IBD) encompasses two major chronic disorders—ulcerative colitis and Crohn’s disease—each characterized by relapsing episodes of gastrointestinal inflammation. Although they share certain clinical features, their patterns of involvement and manifestations differ in ways that aid diagnosis and guide management.Ulcerative ColitisUlcerative colitis is limited to the colon and rectum and involves continuous inflammation of the mucosal layer. The disease course is marked...

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Murine Ileocolic Bowel Resection with Primary Anastomosis
08:49

Murine Ileocolic Bowel Resection with Primary Anastomosis

Published on: October 29, 2014

Anorectal Crohn's disease.

Robert T Lewis1, David J Maron

  • 1Department of Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA.

The Surgical Clinics of North America
|January 30, 2010
PubMed
Summary
This summary is machine-generated.

Perianal Crohn's disease requires a combined medical and surgical approach for best outcomes. Early intervention with drainage, setons, and medical therapy, alongside surgical options, improves fistula treatment success.

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery

Background:

  • Perianal and rectal symptoms affect one-third of Crohn's disease patients, indicating a more aggressive disease course.
  • Historically, surgery was avoided due to the chronic, relapsing nature of Crohn's disease.

Purpose of the Study:

  • To outline optimal management strategies for anorectal Crohn's disease, particularly perianal fistulae.
  • To emphasize the benefits of combined medical and surgical interventions.

Main Methods:

  • Diagnostic workup includes endoanal ultrasound or pelvic MRI alongside examination under anesthesia.
  • Abscess drainage and seton placement are crucial for active inflammation or complex fistulae.
  • Treatment options range from fistulotomy and anal fistula plugs for simple fistulae to plugs or flaps for complex ones.

Main Results:

  • Combined medical and surgical treatment offers the best success rates for perianal fistulae in Crohn's disease.
  • Medical management includes antibiotics and immunosuppressants like infliximab.
  • Up to 20% of patients may require proctectomy for severe, persistent anorectal disease.

Conclusions:

  • A multidisciplinary approach integrating medical and surgical interventions is essential for managing anorectal Crohn's disease.
  • Accurate disease characterization and timely intervention are key to successful fistula treatment.
  • Proctectomy remains an option for refractory cases.