Evolución de los pacientes con enfermedad de Crohn de colon operados con el diagnóstico de colitis ulcerosa

Translated title of the contribution: Analysis of the outcome of patients with Crohn's colitis after surgery with the diagnosis of ulcerative colitis

Álvaro D. Zúñiga, Alejandro C. Zárate, Demian M. Fullerton, Ignacio G. Duarte, Manuel L. Álvarez, Carlos V. Quintana

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Bakground: Proctocolectomy with ileal pouch-anal anastomosis (IPAA) is at present the procedure of choice for elective surgical treatment of ulcerative colitis (UC). Colectomy and ileorectal anastomosis (IRA) can be indicated in selected patients. Some patients submitted to these operations for apparent UC may subsequently evolve as Crohn's disease (CD). Objective: To report the course and prognosis of patients who evolved as CD after surgical treatment for apparent UC. Material and method: All the patients who had a surgical treatment for UC, from 1978 to 2003 were included. We identified the patients in which on follow-up the diagnosis changed to CD. Of these patients surgical variables and follow up were analyzed. Results: 114 patients were operated in this period for UC. In 9 patients (8%) their diagnosis changed to CD, based principally on subsequent clinical course and/or histological study: 3 of 20 (15%) after a total colectomy and IRA and in 6 of 84 (7%) after a proctocolectomy with IPAA. The anal canal and perineum were the most frequent localization of CD. Treatment included surgical procedures and medical treatment with anti-inflammatory and/or inmunomodulators. Two patients with a colectomy with IRA needed a proctectomy and ileostomy. Removal of ileal pouch was necessary on 1 of 6 with IPAA. In conclusion a minority of patients operated with the diagnosis of UC evolved as CD. Combined medical and surgical treatment contributed to a low rate of ileal pouch lost.

Translated title of the contributionAnalysis of the outcome of patients with Crohn's colitis after surgery with the diagnosis of ulcerative colitis
Original languageSpanish
Pages (from-to)35-40
Number of pages6
JournalRevista Chilena de Cirugia
Volume60
Issue number1
StatePublished - 2008
Externally publishedYes

Keywords

  • Crohn disease
  • Ileal pouch
  • Ulcerative colitis

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