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Surgical aspects of inflammatory bowel diseases in pediatric and adolescent age groups
Khaled El-Asmar1, Ehab El-Shafei2, Mohammed Abdel-Latif3
1Pediatric surgery department, Ain Shams University, 14 mostafa sadek el-rafeay, Heliopolis, 11361, Cairo, Egypt. khaled.elasmar@med.asu.edu.eg.
Insights
Pediatric inflammatory bowel disease (IBD) surgery requires careful timing. Surgical intervention for pediatric IBD can lead to complications, necessitating a multidisciplinary approach for optimal management.
Area of Science:
- Pediatric surgery
- Gastroenterology
- Inflammatory Bowel Disease (IBD) management
Background:
- Pediatric inflammatory bowel disease (IBD) is increasingly diagnosed.
- Early-stage IBD in children is linked to higher complication rates and increased need for surgery.
Purpose of the Study:
- To analyze surgical interventions in pediatric and adolescent IBD patients.
- To evaluate outcomes and complications associated with different surgical procedures for ulcerative colitis and Crohn's disease.
Main Methods:
- Retrospective analysis of 25 pediatric and adolescent IBD patients undergoing surgery between January 2010 and June 2015.
- Patients were divided into two groups: ulcerative colitis (UC) and Crohn's disease (CD).
- Surgical procedures included colectomies, ileo-anal anastomosis for UC, and various interventions for CD based on indications like obstruction and fistula.
Main Results:
- Group I (UC) had 15 patients with a mean age of 10.6 years; 7 experienced postoperative complications including pelvic abscess, wound infection, and pouchitis.
- Group II (CD) had 10 patients with a mean age of 6.6 years; 2 had recurrent symptoms after stricturoplasty.
- The average time from diagnosis to surgery was 2.4 years.
Conclusions:
- Effective management of pediatric IBD cases necessitates a multidisciplinary team approach.
- The decision for surgical intervention in pediatric IBD should consider disease severity and potential surgical complications.
Background:
Inflammatory bowel disease (IBD) is increasingly encountered in children. Early disease is associated with higher complication rate with increased incidence of surgical intervention.
Patients And Methods:
From January 2010 to June 2015, 25 patients in the pediatric and adolescent age groups with IBD underwent surgical intervention in our center. They were classified into two groups. Group I included 15 patients with ulcerative colitis where 5 cases had left colon disease underwent left colectomy, while 10 cases had pancolonic disease underwent total colectomy and anal mucosectomy with ileo-anal or ileal pouch-anal anastomosis with covering ileostomy. Group II included 10 cases with Crohn's disease where the indications for surgery were intestinal obstruction in seven cases, fulminant perianal infection with septic shock in one, perianal fistula and ulcers in one, and growth failure due to resistant intestinal fistula in one.
Results:
Group I included eight males and seven females; mean age at surgery was 10.6 years. There were postoperative complications in seven cases in the form of pelvic abscess and wound infection in one, wound infection in two, and recurrent pouchitis in four cases. Group II contained eight males and two females; mean age at surgery was 6.6 years. Two cases had recurrent symptoms after stricturoplasty. The mean length of time from diagnosis to surgery was 2.4 years (ranging from 6 to 36 months).
Conclusion:
A multidisciplinary team is mandatory for proper management of IBD cases. The risk of the disease and the expected surgical complications determine the timing of surgical interference.
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