Management of Crohn's Disease and Complications in Patients With Ostomies.

Fecal diversion with ostomy construction can be a temporary or definitive surgical measure for the treatment of refractory inflammatory bowel disease (IBD). However, the fecal diversion surgery is associated with various stoma, peristomal complications, and recurrence or occurrence of de novo small...

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Publicado en:Inflammatory Bowel Diseases Vol. 24; no. 6; pp. 1167 - 1185
Autores principales: Wang, Xinying, Shen, Bo
Formato: diagnostic images pictorial review tables/charts Journal Article
Publicado: Oxford University Press / USA Jun2018
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Oxford University Press / USA
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        atl: Management of Crohn's Disease and Complications in Patients With Ostomies.
      aug:
        au:
          Wang, Xinying
          Shen, Bo
        affil: Department of Gastroenterology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
      sug:
        subj:
          Crohn Disease Surgery
          Ostomy Adverse Effects
          Postoperative Complications
          Inflammatory Bowel Diseases Surgery
          Pyoderma Gangrenosum Therapy
          Immunologic Factors Therapeutic Use
          Biological Therapy
          Reoperation
          Crohn Disease Diagnosis
          Endoscopy Methods
          Mesalamine Therapeutic Use
          Antibiotics Therapeutic Use
          Tumor Necrosis Factor
          Adrenal Cortex Hormones
          Phenotype
          Treatment Outcomes
      ab: Fecal diversion with ostomy construction can be a temporary or definitive surgical measure for the treatment of refractory inflammatory bowel disease (IBD). However, the fecal diversion surgery is associated with various stoma, peristomal complications, and recurrence or occurrence of de novo small bowel Crohn's disease (CD). Stoma complications often need enterostomal therapy or surgical revision. Peristomal cutaneous lesions, such as pyoderma gangrenosum, usually require immunomodulator or biological therapy. Routine monitoring for occurrence or recurrence of CD with endoscopy or imaging should be performed, and prophylaxis with mesalamines, antibiotics, immunomodulators, or anti-TNFα or anti-integrin agents is needed for patients at risk. Those agents, along with corticosteroids, may also be used for the treatment of CD of the neo-small intestine, particularly inflammatory and fistulizing phenotypes. Endoscopic balloon dilation or endoscopic stricturotomy via stoma is safe and feasible to treat short (<4–5 cm), straight strictures in the neo-small intestine. Medically or endoscopically refractory fibrostenotic disease usually requires surgical intervention, with bowel-sparing stricturoplasty being the surgical treatment of choice.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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