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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
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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

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