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2009 | 81 | 4 | 198-202
Article title

Severe Course of Crohn's Disease Complicated with Multiple Peristomal Fistulas

Content
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Languages of publication
EN
Abstracts
EN
To date healthy male, 51, was admitted to hospital for abdominal pain and body weight loss of 10 kilograms within 6 weeks. Soon after admittance the patient's condition deteriorated and he was operated on for ileus. The Hartman's resection of sigmoid colon was the option for obstructive tumour. First signs of stoma complications were being reported from day 16 on and soon overt multiple fistula formation was diagnosed. Systemic and site treatment was involved (5-ASA, steroids). Nevertheless, the patient's condition was not improving within following 8 months, which led to succeeding hospitalisations, finally, infliximab therapy was the successful one. On patient's demand the hind-gut reconstruction was performed. Partial resection of involved bowel and stoma followed by end-to-end hind-gut reconstruction was the option. Up to now (i.e. 8 months after the reconstruction) the patient remains in good condition.
Publisher

Year
Volume
81
Issue
4
Pages
198-202
Physical description
Dates
published
1 - 4 - 2009
online
14 - 5 - 2009
Contributors
  • Department of General and Vascular Surgery, Sub-Department of Gastroenterological and Colorectal Surgery, 2 Dr J. Biziel Memorial University Hospital, Bydgoszcz
  • Department of Gastroenterology, 2 Dr J. Biziel Memorial University Hospital, Bydgoszcz
  • Department of General and Vascular Surgery, Sub-Department of Gastroenterological and Colorectal Surgery, 2 Dr J. Biziel Memorial University Hospital, Bydgoszcz
References
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  • Podolsky DK: Inflammatory bowel disease. NEJM 2002; 347: 417-29.
  • Gasche C, Scholinerich J, Brynskov J, et al: A simple classification of Crohn's disease: Report of the Working Party for the World Congresses of Gastroenterology, Vienna 1998. Inflammatory Bowel Diseases 2000; 6: 8-15.
  • Poritz LS, Gagliano GA, McLeod RS, et al.: Surgical management of entero and colocutaneous fistulae in Crohn's disease: 17 year's experience Int J Colorectal Dis 2004; 19(5): 481-85.
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  • Dejaco C, Harrer M, Waldhoer T, et al.: Antibiotics and azathioprine for the treatment of perianal fistulas in Crohn's disease. Aliment Pharmacol Ther 2003; 18: 1113-20.[PubMed][Crossref]
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  • Colombel JF, Loftus EV Jr., Tremaine WJ, et al.: Early postoperative complications are not increased in patients with Crohn's disease treated perioperatively with infliximab or immunosuppressive therapy. Am J Gastroenterol 2004; 99: 878-83.[PubMed][Crossref]
  • Marchal L, D'Haens G, Van Assche G, et al.: The risk of post-operative compli cations associated with infliximab therapy for Crohn's disease: a controlled cohort study. Aliment Pharmacol Ther 2004; 19: 740-54.
  • Deshpande AR, Abreu MT: Combination Therapy With Infliximab and Immunomodulators: Is the Glass Half Empty. Gastroenterology 2008;134: 2161-63.
  • Van Assche G, Magdaleine-Beuzelin CD, Haens G, et al.: Withdrawal of Immunosuppresion in Crohn's Disease Treated With Scheduled Infliximab Maintenance: A Randomized Trial. Gastroenterology 2008; 134: 1861-68.
Document Type
Publication order reference
Identifiers
YADDA identifier
bwmeta1.element.-psjd-doi-10_2478_v10035-009-0030-0
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