Surgical strategies in paediatric inflammatory bowel disease

被引:11
作者
Baillie, Colin T. [1 ]
Smith, Jennifer A. [1 ]
机构
[1] Royal Liverpool Childrens Hosp, NHS Trust, Dept Paediat Surg, Liverpool L12 2AP, Merseyside, England
关键词
Inflammatory bowel disease; Ulcerative colitis; Crohn's disease; Paediatric; Surgery; POUCH-ANAL ANASTOMOSIS; PERIANAL CROHNS-DISEASE; TO-END ANASTOMOSIS; ENDOSCOPIC BALLOON DILATATION; SEVERE ULCERATIVE-COLITIS; ILEAL POUCH; RISK-FACTORS; RESTORATIVE PROCTOCOLECTOMY; INFLIXIMAB THERAPY; ILEORECTAL ANASTOMOSIS;
D O I
10.3748/wjg.v21.i20.6101
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Inflammatory bowel disease (IBD) comprises two distinct but related chronic relapsing inflammatory conditions affecting different parts of the gastrointestinal tract. Crohn's disease is characterised by a patchy transmural inflammation affecting both small and large bowel segments with several distinct phenotypic presentations. Ulcerative colitis classically presents as mucosal inflammation of the rectosigmoid (distal colitis), variably extending in a contiguous manner more proximally through the colon but not beyond the caecum (pancolitis). This article highlights aspects of the presentation, diagnosis, and management of IBD that have relevance for paediatric practice with particular emphasis on surgical considerations. Since 25% of IBD cases present in childhood or teenage years, the unique considerations and challenges of paediatric management should be widely appreciated. Conversely, we argue that the organizational separation of the paediatric and adult healthcare worlds has often resulted in late adoption of new approaches particularly in paediatric surgical practice.
引用
收藏
页码:6101 / 6116
页数:16
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