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Clin Colon Rectal Surg 2013; 26(02): 084-089
DOI: 10.1055/s-0033-1348046
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Colonic Crohn Disease

Traci L. Hedrick
1   Department of Surgery, University of Virginia Health System, Charlottesville, Virginia
,
Charles M. Friel
1   Department of Surgery, University of Virginia Health System, Charlottesville, Virginia
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Publikationsdatum:
27. Juni 2013 (online)

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Abstract

Colonic Crohn disease is a complicated disease entity that requires a multidisciplinary effort on the part of the surgeon, gastroenterologist, and pathologist. Crohn disease affects ∼500,000 people in North America with nearly 300,000 people suffering from colonic manifestations. This represents a significant portion of the patient population in the typical colorectal surgeon's practice. As such, an intimate understanding of the disease process, presentation, and treatment options is imperative. In this article, the authors review the clinical manifestations, diagnosis, and medical and surgical treatment options with a focus on current strategies for surgical management.

Keywords

Crohn disease - colitis - surgical management
 

  • References

  • 1 Loftus Jr EV, Schoenfeld P, Sandborn WJ. The epidemiology and natural history of Crohn's disease in population-based patient cohorts from North America: a systematic review. Aliment Pharmacol Ther 2002; 16 (1) 51-60
    CrossrefPubMedGoogle Scholar
  • 2 Mills S, Stamos MJ. Colonic Crohn's disease. Clin Colon Rectal Surg 2007; 20 (4) 309-313
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 3 Robert JR, Sachar DB, Greenstein AJ. Severe gastrointestinal hemorrhage in Crohn's disease. Ann Surg 1991; 213 (3) 207-211
    CrossrefPubMedGoogle Scholar
  • 4 Maykel JA, Hagerman G, Mellgren AF , et al. Crohn's colitis: the incidence of dysplasia and adenocarcinoma in surgical patients. Dis Colon Rectum 2006; 49 (7) 950-957
    CrossrefPubMedGoogle Scholar
  • 5 Choi PM, Zelig MP. Similarity of colorectal cancer in Crohn's disease and ulcerative colitis: implications for carcinogenesis and prevention. Gut 1994; 35 (7) 950-954
    CrossrefPubMedGoogle Scholar
  • 6 Richards ME, Rickert RR, Nance FC. Crohn's disease-associated carcinoma. A poorly recognized complication of inflammatory bowel disease. Ann Surg 1989; 209 (6) 764-773
    CrossrefPubMedGoogle Scholar
  • 7 Petras RE, Mir-Madjlessi SH, Farmer RG. Crohn's disease and intestinal carcinoma. A report of 11 cases with emphasis on associated epithelial dysplasia. Gastroenterology 1987; 93 (6) 1307-1314
    PubMedGoogle Scholar
  • 8 Bernstein CN, Shanahan F, Weinstein WM. Are we telling patients the truth about surveillance colonoscopy in ulcerative colitis?. Lancet 1994; 343 (8889) 71-74
    CrossrefPubMedGoogle Scholar
  • 9 Gorfine SR, Bauer JJ, Harris MT, Kreel I. Dysplasia complicating chronic ulcerative colitis: is immediate colectomy warranted?. Dis Colon Rectum 2000; 43 (11) 1575-1581
    CrossrefPubMedGoogle Scholar
  • 10 Lim CH, Dixon MF, Vail A, Forman D, Lynch DA, Axon AT. Ten year follow up of ulcerative colitis patients with and without low grade dysplasia. Gut 2003; 52 (8) 1127-1132
    CrossrefPubMedGoogle Scholar
  • 11 Blackstone MO, Riddell RH, Rogers BH, Levin B. Dysplasia-associated lesion or mass (DALM) detected by colonoscopy in long-standing ulcerative colitis: an indication for colectomy. Gastroenterology 1981; 80 (2) 366-374
    CrossrefPubMedGoogle Scholar
  • 12 Suzuki K, Muto T, Shinozaki M, Yokoyama T, Matsuda K, Masaki T. Differential diagnosis of dysplasia-associated lesion or mass and coincidental adenoma in ulcerative colitis. Dis Colon Rectum 1998; 41 (3) 322-327
    CrossrefPubMedGoogle Scholar
  • 13 Rubin PH, Friedman S, Harpaz N , et al. Colonoscopic polypectomy in chronic colitis: conservative management after endoscopic resection of dysplastic polyps. Gastroenterology 1999; 117 (6) 1295-1300
    CrossrefPubMedGoogle Scholar
  • 14 Walsh SV, Loda M, Torres CM, Antonioli D, Odze RD. P53 and beta catenin expression in chronic ulcerative colitis—associated polypoid dysplasia and sporadic adenomas: an immunohistochemical study. Am J Surg Pathol 1999; 23 (8) 963-969
    CrossrefPubMedGoogle Scholar
  • 15 Cairns SR, Scholefield JH, Steele RJ , et al; British Society of Gastroenterology, Association of Coloproctology for Great Britain and Ireland. Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002). Gut 2010; 59 (5) 666-689
    CrossrefPubMedGoogle Scholar
  • 16 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
    CrossrefPubMedGoogle Scholar
  • 17 Khan KJ, Ullman TA, Ford AC , et al. Antibiotic therapy in inflammatory bowel disease: a systematic review and meta-analysis. Am J Gastroenterol 2011; 106 (4) 661-673
    CrossrefPubMedGoogle Scholar
  • 18 Fichera A, McCormack R, Rubin MA, Hurst RD, Michelassi F. Long-term outcome of surgically treated Crohn's colitis: a prospective study. Dis Colon Rectum 2005; 48 (5) 963-969
    CrossrefPubMedGoogle Scholar
  • 19 Amiot A, Gornet JM, Baudry C , et al. Crohn's disease recurrence after total proctocolectomy with definitive ileostomy. Dig Liver Dis 2011; 43 (9) 698-702
    CrossrefPubMedGoogle Scholar
  • 20 Ilnyckyj A. Surgical treatment of inflammatory bowel diseases and pregnancy. Best Pract Res Clin Gastroenterol 2007; 21 (5) 819-834
    CrossrefPubMedGoogle Scholar
  • 21 Goligher JC. The long-term results of excisional surgery for primary and recurrent Crohn's disease of the large intestine. Dis Colon Rectum 1985; 28 (1) 51-55
    CrossrefPubMedGoogle Scholar
  • 22 Hyman NH, Cataldo P, Osler T. Urgent subtotal colectomy for severe inflammatory bowel disease. Dis Colon Rectum 2005; 48 (1) 70-73
    CrossrefPubMedGoogle Scholar
  • 23 Cirincione E, Gorfine SR, Bauer JJ. Is Hartmann's procedure safe in Crohn's disease? Report of three cases. Dis Colon Rectum 2000; 43 (4) 544-547
    CrossrefPubMedGoogle Scholar
  • 24 Longo WE, Oakley JR, Lavery IC, Church JM, Fazio VW. Outcome of ileorectal anastomosis for Crohn's colitis. Dis Colon Rectum 1992; 35 (11) 1066-1071
    CrossrefPubMedGoogle Scholar
  • 25 Martel P, Betton PO, Gallot D, Malafosse M. Crohn's colitis: experience with segmental resections; results in a series of 84 patients. J Am Coll Surg 2002; 194 (4) 448-453
    CrossrefPubMedGoogle Scholar
  • 26 Prabhakar LP, Laramee C, Nelson H, Dozois RR. Avoiding a stoma: role for segmental or abdominal colectomy in Crohn's colitis. Dis Colon Rectum 1997; 40 (1) 71-78
    CrossrefPubMedGoogle Scholar
  • 27 Andersson P, Olaison G, Hallböök O, Sjödahl R. Segmental resection or subtotal colectomy in Crohn's colitis?. Dis Colon Rectum 2002; 45 (1) 47-53
    CrossrefPubMedGoogle Scholar
  • 28 Sanfey H, Bayless TM, Cameron JL. Crohn's disease of the colon. Is there a role for limited resection?. Am J Surg 1984; 147 (1) 38-42
    CrossrefPubMedGoogle Scholar
  • 29 Longo WE, Ballantyne GH, Cahow CE. Treatment of Crohn's colitis. Segmental or total colectomy?. Arch Surg 1988; 123 (5) 588-590
    CrossrefPubMedGoogle Scholar
  • 30 Melton GB, Fazio VW, Kiran RP , et al. Long-term outcomes with ileal pouch-anal anastomosis and Crohn's disease: pouch retention and implications of delayed diagnosis. Ann Surg 2008; 248 (4) 608-616
    PubMedGoogle Scholar
  • 31 Regimbeau JM, Panis Y, Pocard M , et al. Long-term results of ileal pouch-anal anastomosis for colorectal Crohn's disease. Dis Colon Rectum 2001; 44 (6) 769-778
    CrossrefPubMedGoogle Scholar