Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-19T16:56:22.176Z Has data issue: false hasContentIssue false

27 - Inflammatory bowel disease in children

from Part IV - Abdomen

Published online by Cambridge University Press:  08 January 2010

By
Frederick Alexander
Edited by
Mark D. Stringer ,
Keith T. Oldham  and
Pierre D. E. Mouriquand
Frederick Alexander
Affiliation:
Department of Pediatric Surgery, Cleveland Clinic, OH, USA
Mark D. Stringer
Affiliation:
University of Otago, New Zealand
Keith T. Oldham
Affiliation:
Children's Hospital of Wisconsin
Pierre D. E. Mouriquand
Affiliation:
Debrousse Hospital, Lyon
Get access

Summary

Introduction

Inflammatory bowel disease is a chronic intestinal disease of unknown etiology that takes several different forms including Crohn's disease and ulcerative colitis. Typically the inflammation in Crohn's disease is panenteric and full-thickness while in ulcerative colitis it is usually limited to colorectal mucosa. These archetypal diseases may sometimes be difficult to distinguish because they may have similar presenting features, especially when there is colonic involvement and both are associated with similar extra-intestinal manifestations. Histologically, Crohn's disease is characterized by apthous ulceration and cobblestoning with rectal sparing while ulcerative colitis is manifested by crypt abscesses and depletion of goblet cells with continuous inflammation always involving the rectum. However, in as many as 10% or more of patients, the histology may be indeterminate. The surgical treatment for Crohn's disease and ulcerative colitis and the outcomes vary considerably, and these are the subjects of this chapter.

Crohn's disease

Epidemiology

Crohn's disease is more common than ulcerative colitis, occurring in 11 cases per 100000 population per year, versus 2.3 cases of ulcerative colitis per 100000 population per year in the pediatric age group. The incidence of Crohn's disease is age specific, occurring in 2.5 cases per 100000 population per year in persons less than 15 years of age compared to 16 cases per 100 000 population per year in persons 15–19 years of age. Males and females are equally affected and Crohn's disease occurs more commonly in the Caucasian and Jewish populations compared to other ethnic groups.

Type
Chapter
Information
Pediatric Surgery and Urology
Long-Term Outcomes
 , pp. 351 - 361
Publisher: Cambridge University Press
Print publication year: 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Grand, R. J., Ramakrishna, J., Calenda, K. A.Inflammatory bowel disease in the pediatric patient. Gastoenterol. Clin. N. Am. 1995; 24(3):613–632.Google ScholarPubMed
Michner, W. M., Caulfield, M., Wyllie, R., & Farmer, R. G.Management of inflammatory bowel disease: 30 years of observation. Clevel. Clin. J. Med. 1990; 57:685–691.CrossRefGoogle Scholar
Gilat, T.Incidence of inflammatory bowel disease: going up or down?Gastroenterology 1983; 85(1):196–197.Google ScholarPubMed
Michener, W. M., Caufield, M., Farmer, R. G., Wyllie, R., Cotman, K., & Hertzer, J.Genetic counseling and family history in IBD: 30 years experience at The Cleveland Clinic. Can. J. Gastroenterol. 1990; 4:350–354.CrossRefGoogle Scholar
Fiocchi, C.From immune activation to gut tissue injury: the pieces of the puzzle are coming together. Gastroenterology 1999; 117:1238–1241.CrossRefGoogle ScholarPubMed
Levin, K. E., Pemberton, J. H., Phillips, S. F., Zinmeister, A. R., & Pezim, M. E.Role of oxygen free radicals in the etiology of pouchitis. Dis. Colon Rectum 1992; 35(5):452–456.CrossRefGoogle ScholarPubMed
Lock, M. R., Farmer, R. G., Fazio, V. W., Jagelman, D. G., Lavery, I. C., & Weakley, F. L.Recurrence and reoperation for Crohn's Disease: the role of disease location in prognosis. N. Engl. J. Med. 1981; 304(26):1586–1588.CrossRefGoogle ScholarPubMed
Michener, W. M. & Wyllie, R.Management of children and adolescents with inflammatory bowel disease. Med. Clin. N. Am. 1990; 74:103–117.CrossRefGoogle ScholarPubMed
Hyams, J. S.Extaintestinal manifestations of inflammatory bowel disese. J. Pediatr. Gastroenterol. Nutr. 1994; 19:7–21.CrossRefGoogle Scholar
Kotanagi, H., Kramer, K., Fazio, V. W., & Petras, R. E.Do microscopic abnormalities at resecton margins correlate with increased anastomotic recurrence in Crohn's Disease?Dis. Colon Rectum 1991; 34(10):909–916.CrossRefGoogle Scholar
Oliva, R. T., Wyllie, R., Alexander, F.et al.The results of strictureplasty in pediatric patients with multifocal Crohn Disease. J. Pediatr. Gastroenterol. Nutrit. 1994; 18:307–311.Google Scholar
Tiandra, J. J., Fazio, V. W.et al.Surgery for Crohns colitis. Int. Surg. 1992; 77:9–14.Google Scholar
Alexander, F., Sarigol, S., DiFiore, J.et al.Fate of the pouch in 151 pediatric patients after ileal pouch anal anastomosis. J. Pediatr. Surg. 2003; 38(1):78–82.CrossRefGoogle ScholarPubMed
Cintron, J. R., Park, J. J., Orsay, C. P.et al.Repair of fistulas–in-ano using fibrin adhesive. Dis. Colon Rectum 2000; 43(7):944–950.CrossRefGoogle ScholarPubMed
Sedgwick, , D. M., Barton, J. R., Hamer-Hodges, D. W. et al.Population-based study of surgery in juvenile onset Crohn's Disease. Br. J. Surg. 1991; 78(2):171–175.CrossRefGoogle ScholarPubMed
Wilmore, D.Short bowel syndrome. World J. Surg. 2000; 24:1487–1493.CrossRefGoogle ScholarPubMed
Fazio, V. W. Galandiuk, S. et al.Strictureplasty in Crohn's disease. Ann. Surg. 1989; 210:621–625.CrossRefGoogle ScholarPubMed
Alexander-Williams, J. & Haynes, I. G.Conservative operations for Crohn's disease of the small bowel. World. J. Surg. 1985; 9:945–951.CrossRefGoogle ScholarPubMed
Dietz, D. W., Lauret, S., Strong, S. A.et al.Safety and long term efficacy of strictureplasty in 314 patients with obstructing small bowel Crohn's disease. J. Am. Coll. Surg. 2001; 192:333–337.CrossRefGoogle Scholar
Longo, W. E., Oakley, J. R ., Lavery, I. C., Church, J. M., & Fazio, V. W.Outcome of ileorectal anastomosis for Crohns Colitis. Dis. Colon Rectum 1992; 35(11):1066–1070.CrossRefGoogle Scholar
Orkin, B. A. & Telander, R. L.The effect of intra-abdominal resection or fecal diversion on perianal disease in pediatric Crohn's disease. J. Pediatr. Surg. 1985; 20(4):343–347.CrossRefGoogle ScholarPubMed
Canfield, M. E. & Michener, W. Ulcerative colitis. In Wyllie, R. & Hyams, J. S., eds. Pediatric Gastrointestinal Disease: Pathophysiology, Diagnosis and Management. Philadelphia: W. B. Saunders, 1993: 765–787.Google Scholar
Mir-Madjlessi, S. H., Michener, W. M., & Farmer, R. G.Course and prognosis of idiopathic ulcerative proctosigmoiditis in young patients. J. Pediatr. Gastroenterol. Nutr. 1986; 5:570–575.CrossRefGoogle ScholarPubMed
Provjansky, R., Fawcett, P. T., Gibney, K. M., Treem, W. R., & Hyams, J. S.Examination of anti-neutrophil cytoplasmic antibodies in childhood inflammatory bowel disease. J. Pediatr. Gastroenterol. Nutr. 1993; 17:193–197.CrossRefGoogle Scholar
Broekroelofs, J., Mulder, A. H., Nelis, G. F., Westerveld, B. D., Tervaert, J. W., & Kallenberg, C. G.Anti-neutrophil cytoplasmic antibiodies (ANCA) in sera from patients with inflammatory bowel disease (IBD). Relation to disease pattern and disease activity. Dig. Dis. Sci. 1994; 39:545–549.CrossRefGoogle Scholar
Michener, W. M., Whelan, G., Greenstreet, R. L., & Farmer, R. G.Comparison of the clinical features of Crohn's Disease and Ulcerative Colitis with onset in childhood or adolescence. Clevel. Clin. J. Med. 1982; 49:13–16.CrossRefGoogle ScholarPubMed
Ravitch, M. M. & Sabiston, D. C.Anal ileostomy with preservation of the sphincter. Surg. Gynecol. Obstet. 1947; 84:1095–1099.Google ScholarPubMed
Martin, L. W., Torres, A. M., Fischer, J. E., Alexander, F.The critical level for preservation of continence in the ileo anal anastomosis. J. Pediatr. Surg. 1985; 20:664–667.CrossRefGoogle Scholar
Davis, C., Alexander, F., Lavery, I. C., & Fazio, V. W.Results of mucosal proctectomy versus extra rectal dissection for ulcerative colitis and familial polyposis in children and young adults. J. Pediatr. Surg. 1994; 29(2):305–309.CrossRefGoogle Scholar
Ziv, Y., Fazio, V. W., Sirimarco, M. T., Lavery, I. C., Goldblum, J. R., & Petras, R. E.Incidence risk factors, and treatment of dysplasia in the anal transition zone after ileal pouch anal anastomosis. Dis. Colon Rectum 1994; 37(12):1281–1285.CrossRefGoogle Scholar
Dozois, R. R., Kelly, K. A., Welling, D. R.et al.Ileal pouch-anal anastomosis: comparison of results in familial adenomastous polyposis and chronic ulcerative colitis. Ann. Surg. 1989; 210(3):268–271.CrossRefGoogle ScholarPubMed
Ozuner, G., Hull, T., Lee, P., & Fazio, V. W.What happens to a pelvic pouch when a fistula develops?Dis. Colon Rectum 1997; 40(5):543–547.CrossRefGoogle ScholarPubMed
Foley, E. F., Schoetz, D. J., Roberts, P. L.et al.Rediversion after ileal pouch–anal anastomosis. Causes of failures and predictors of subsequent pouch salvages. Dis. Colon Rectum 1995; 28(8):793–798.CrossRefGoogle Scholar
Fazio, V. W. & Tjandra, J. J.Pouch advancement and neoileal-anal anastomosis for anastomosed stricture and anovaginal fistula complicating restorative proctocolectomy. Br. J. Surg. 1992; 79:694–696.CrossRefGoogle Scholar
Macrae, H. M., McLeod, R. S., Cohen, Z., Connor, B. I., & Cheong, E. N.Risk factors for pelvic pouch failure. Dis. Colon Rectum 1997; 40(3):257–262.CrossRefGoogle ScholarPubMed
Breen, E. M., Schoetz, D. J., Marcello, P. W.et al.Functional results after perineal complications of ileal pouch anal anastomosis. Dis. Colon Rectum. 1998; 41(6):691–695.CrossRefGoogle ScholarPubMed
Devroede, G. J., Taylor, W. T., Sauer, W. G., Jackman, R. J., & Stickler, G. B.Cancer risk and life expectancy of children with ulcerative colitis. N. Engl. J. Med. 1971; 285(1):17–21.CrossRefGoogle ScholarPubMed
Collins, R. H., Feldman, M., & Fordtran, J. S.Colon cancer, dysplasia, and surveillance in patients with ulcerative colitis. A critical review. N. Engl. J. Med. 1987; 316(26):1654–1658.CrossRefGoogle ScholarPubMed
Bansai, P. & Sonnenberg, A.Risk factors of colorectal cancer in inflammatory bowel disease. Am. J. Gastroenterol. 1996; 91(1):44–48.Google Scholar
Greenstern, A. J., Sachar, D. B., Smith, H., Janowitz, H. D., & Aufses, A. H. Jr.A comparison of cancer risk in Crohn's disease and ulcerative colitis. Cancer 1981; (12):2742–2745.3.0.CO;2-P>CrossRefGoogle Scholar
Michener, W. M., Farmer, R. G., & Mortimer, E. A.Long-term prognosis of ulcerative colitis with onset in childhood or adolescence. J. Clin. Gastroenterol. 1979; 1:301–305.CrossRefGoogle ScholarPubMed
Jonsson, B., Ahsgren, L., Anderson, L. O., Stenberg, R., & Rutegard, J.Colorectal cancer surveillance in patients with ulcerative colitis. Br. J. Surg. 1994; 81:689–691.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×