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[Chronic inflammatory bowel diseases in pediatric surgery]
Langenbecks Archiv Fur Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft Fur Chirurgie. Kongress
|February 5, 1999
Insights
Crohn
Area of Science:
- Pediatric Gastroenterology
- Pediatric Surgery
- Inflammatory Bowel Disease Research
Context:
- Crohn's disease (CD) affects 147 children, with 23% requiring surgery.
- Surgical intervention often occurs at a median age of 12.5 years, 4.5 years post-diagnosis.
- Current surgical indications in pediatric CD lack specific guidance for pubertal timing.
Purpose:
- To investigate the optimal timing for surgical intervention in pediatric Crohn's disease.
- To evaluate the impact of surgical timing on growth and pubertal development.
- To identify key factors influencing surgical decisions in prepubertal and pubertal children with CD.
Summary:
- 34 out of 147 children (23%) with Crohn's disease (CD) underwent surgery.
- Optimal surgical timing is crucial, particularly considering pubertal development, growth velocity, and bone age.
- Delayed surgery may lead to compromised growth, pubertal delay, and reduced quality of life.
Impact:
- Highlights the need for precise surgical timing in pediatric Crohn's disease management.
- Emphasizes the long-term consequences of suboptimal surgical timing on child development.
- Informs clinical practice regarding the assessment of prepubertal children with CD for timely surgical intervention.
Abstract:
Out of 147 children suffering from Crohn's disease (CD), 34 needed surgery (23%) at an age of 12.5 years, usually 4.5 years after conservative treatment. Besides acute and planned indications for surgery, the relative indication during puberty requires further knowledge of the influence of growth velocity rates for weight and height, bone retardation, Tanner stage, chronological age and open epiphysial plates. Expecting 2.3 years of postoperative remission, the chance is often missed to operate on the prepubertal child at an optimal time leading to growth failure, retardation of pubertal development and diminished quality of life.