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Atypical course of Crohn’s disease with colonic involvement in a young patient


Authors: P. Vítek 1,2;  I. Mikoviny Kajzrlíková 1;  Přemysl Falt 2,3;  P. Zonča 2,4;  J. Platoš 1;  M. Lukáš 5
Authors‘ workplace: Beskydské Gastrocentrum, Interní oddělení, Nemocnice ve Frýdku‑ Místku, p.  o. 1;  LF OU v Ostravě 2;  Centrum péče o zažívací trakt, Vítkovická nemocnice a.  s., Ostrava 3;  Chirurgická klinika LF OU a FN Ostrava 4;  Klinické a výzkumné centrum pro střevní záněty ISCARE I. V. F. a. s., Praha 5
Published in: Gastroent Hepatol 2016; 70(1): 61-64
Category: IBD: Case Report
doi: https://doi.org/10.14735/amgh201661

Overview

A case of a young man treated by acute colectomy for severe colitis refractory to pharmacologic therapy is presented. Based on the presence of new atypical ulcers in his rectal stump, the disease was reclassified from ulcerative colitis to Crohn’s disease before subsequent reconstructive surgery. Ileorectal anastomosis was prefered to ileal pouch anal anastomosis.

Key words:
Crohn’s disease –  colitis –  colectomy

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
22. 1. 2016

Accepted:
8. 2. 2016


Sources

1. Dignass A, Eliakim R, Magro F et al. Second European evidence‑based consensus on the dia­gnosis and management of ulcerative colitis part 1: definitions and dia­gnosis. J Crohns Colitis 2012; 6(10): 965– 990. doi: 10.1016/ j.crohns.2012.09.003.

2. Turner D, Walsh CM, Steinhart AH et al. Response to corticosteroids in severe ulcerative colitis: a systematic review of the literature and a meta‑regression. Clin Gastroenterol Hepatol 2007; 5(1): 103– 110.

3. Gibson DJ, Heetun ZS, Redmond CE et al.An accelerated infliximab induction regimen reduces the need for early colectomy in patients with acute severe ulcerative colitis. Clin Gastroenterol Hepatol 2015; 13(2): 330– 335. doi: 10.1016/ j.cgh.2014.07.041.

4. Silverberg MS, Satsangi J, Ahmad T et al. Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working party of the 2005 Montreal world congress of gastroenterology. Can J Gastroenterol 2005; 19 (Suppl A): 5A– 36A.

5. Joossens S, Reinisch W, Vermeire S et al. The value of serologic markers in indeterminate colitis: a prospective follow‑up study. Gastroenterology 2002; 122(5): 1242– 1247.

6. Windsor A, Michetti P, Bemelman W et al. The positioning of colectomy in the treatment of ulcerative colitis in the era of bio­logic therapy. Inflamm Bowel Dis 2013; 19(12): 2695– 2703.

7. Holubar SD, Larson DW, Dozois EJ et al. Minimally invasive subtotal colectomy and ileal pouch‑ anal anastomosis for fulminant ulcerative colitis: a reasonable approach? Dis Colon Rectum 2009; 52(2): 187– 192. doi: 10.1007/ DCR.0b013e31819a5cc1.

8. Yu CS, Pemberton JH, Larson D. Ileal pouch-anal anastomosis in patients with indeterminate colitis: long-term results. Dis Colon Rectum 2000; 43(11): 1487– 1496.

Labels
Paediatric gastroenterology Gastroenterology and hepatology Surgery

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Gastroenterology and Hepatology

Issue 1

2016 Issue 1

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