Diagnosis and management of fistulizing Crohn's disease.

Details

Serval ID
serval:BIB_1D24E242F114
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Title
Diagnosis and management of fistulizing Crohn's disease.
Journal
Nature Clinical Practice. Gastroenterology and Hepatology
Author(s)
Nielsen O.H., Rogler G., Hahnloser D., Thomsen O.Ø.
ISSN
1743-4386 (Electronic)
ISSN-L
1743-4378
Publication state
Published
Issued date
2009
Volume
6
Number
2
Pages
92-106
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; ReviewPublication Status: ppublish
Abstract
The transmural inflammation characteristic of Crohn's disease predisposes patients to the formation of fistulas. Up to 50% of patients with Crohn's disease are affected by fistulas, which is a major problem given the considerable morbidity associated with this complication. Appropriate treatment of fistulas requires knowledge of specific pharmacological and surgical therapies. Treatment options depend on the severity of symptoms, fistula location, the number and complexity of fistula tracts, and the presence of rectal complications. Internal fistulas, such as ileoileal or ileocecal fistulas, are mostly asymptomatic and do not require intervention. By contrast, perianal fistulas can be painful and abscesses may develop that require surgical drainage with or without seton placement, transient ileostomy, or in severe cases, proctectomy. This Review describes the epidemiology and pathology of fistulizing Crohn's disease. Particular focus is given to external and perianal fistulas, for which treatment options are well established. Available therapeutic options, including novel therapies, are discussed. Wherever possible, practical and evidence-based treatment regimens for Crohn's disease-associated fistulas are provided.
Keywords
Crohn Disease/complications, Crohn Disease/diagnosis, Humans, Intestinal Fistula/etiology, Intestinal Fistula/therapy, Rectal Fistula/etiology, Rectal Fistula/therapy, Severity of Illness Index, Treatment Outcome
Pubmed
Web of science
Create date
06/10/2014 9:56
Last modification date
20/08/2019 12:53
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