Related Experiment Videos

Clinical features and management of parastomal pyoderma gangrenosum in inflammatory bowel disease

Motoi Uchino1, Hiroki Ikeuchi, Hiroki Matsuoka

  • 1Department of Surgery, Hyogo College of Medicine, Hyogo, Japan. motoi.uchino@nifty.ne.jp

Digestion
|May 16, 2012
PubMed
Abstract

Insights

Peristomal pyoderma gangrenosum (PG) is a rare complication after colorectal surgery. This study found distinct clinical features and onset times for explosive (type R) and indolent (type G) PG, differing between ulcerative colitis and Crohn's disease.

Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Dermatology

Background:

  • Pyoderma gangrenosum (PG) is a rare inflammatory skin condition.
  • PG is often associated with inflammatory bowel disease (IBD), even post-surgery.
  • Peristomal PG, occurring around ostomy sites, requires specific management considerations.

Purpose of the Study:

  • To investigate the clinical features and treatment of peristomal pyoderma gangrenosum (PG).
  • To determine the proper management strategies for peristomal PG.
  • To analyze the differences in PG development between ulcerative colitis and Crohn's disease patients.

Main Methods:

  • Prospective data collection of patients undergoing colorectal surgery with ostomy creation.
  • Classification of peristomal PG into explosive/rapidly spreading (type R) and indolent/gradually spreading (type G) types.
  • Analysis of demographic data, onset, and healing times for each PG type.

Main Results:

  • Overall prevalence of peristomal PG was 1.5% (11/738 patients).
  • Type R PG was more common in ulcerative colitis, while type G was more frequent in Crohn's disease (p=0.01).
  • Type R developed within 6 days, type G at a mean of 52 days post-surgery; healing took 69 and 48 days, respectively.

Conclusions:

  • Peristomal PG is a rare but significant complication following colorectal surgery.
  • Distinct clinical presentations and onset patterns of PG exist between ulcerative colitis and Crohn's disease.
  • Awareness and careful observation are crucial for managing peristomal PG effectively.

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...
Gastritis III: Clinical Manifestations and Management01:23

Gastritis III: Clinical Manifestations and Management

The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
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 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...
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy

Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
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...