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Related Concept Videos

Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

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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:
128
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

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Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
118
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
58
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

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

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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...
324
Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

201
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...
201
Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

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Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
153

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Updated: Jun 14, 2025

Murine Ileocolic Bowel Resection with Primary Anastomosis
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Venous Thromboembolism Prophylaxis Practice Patterns, Outcomes, and Risk Stratification After Surgery for IBD: A

Stefan D Holubar1, Samuel Eisenstein2, Liliana Bordeianou3

  • 1Department of Colon and Rectal Surgery, Cleveland Clinic, Cleveland, Ohio.

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Summary

Enoxaparin reduced venous thromboembolism (VTE) risk after inflammatory bowel disease surgery. This strategy decreased clot risk both before and after hospital discharge, especially for high-risk patients.

Keywords:
ChemoprophylaxisColectomyCrohn’s diseaseDirect oral anticoagulantsIBDIleoanal pouchLow-molecular-weight heparinProctectomyUlcerative colitisVenous thromboembolism

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Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Pharmacology

Background:

  • Optimal venous thromboembolism (VTE) chemoprophylaxis after inflammatory bowel disease (IBD) surgery remains undefined.
  • Post-surgical VTE is a significant concern in patients undergoing colectomy or proctectomy for IBD.

Purpose of the Study:

  • To evaluate the real-world effectiveness of different VTE chemoprophylaxis strategies in IBD patients post-surgery.
  • To identify risk factors for VTE and assess the impact of specific anticoagulants on outcomes.

Main Methods:

  • Retrospective cohort study analyzing 1,797 IBD patients undergoing colectomy/proctectomy from July 2020 to October 2023.
  • Data collected from the National Surgical Quality Improvement Program Inflammatory Bowel Disease Collaborative across 17 centers.
  • Chemoprophylaxis strategies (enoxaparin, unfractionated heparin, extended prophylaxis) were compared for 30-day VTE rates.

Main Results:

  • Overall 30-day VTE rate was 2.4%, with portomesenteric (39%), pulmonary embolism (27%), and upper extremity (18%) clots being most common.
  • Enoxaparin use was associated with significantly lower clot rates (0.57%) compared to unfractionated heparin (2.1%) before discharge (p=0.006).
  • Extended enoxaparin prophylaxis also showed lower clot rates (0.63%) versus no extended prophylaxis (1.4%) (p=0.01).
  • Preoperative systemic inflammatory response syndrome and extended resections were independent risk factors for VTE.
  • Enoxaparin (inpatient and extended) independently lowered clot risk by over 70% before and after discharge.

Conclusions:

  • Enoxaparin-based chemoprophylaxis significantly reduces VTE risk in IBD surgery patients, both inpatient and extended post-discharge.
  • Patients with identified risk factors may particularly benefit from extended enoxaparin prophylaxis.
  • Study limitations include potential generalizability issues and selection bias.