1
|
Heo YJ, Park WK, Kim JC, Lee JK, Kim KY. Diagnosis and Treatment of Anorectal Lesions in Crohn's Disease. JOURNAL OF THE KOREAN SOCIETY OF COLOPROCTOLOGY 2010. [DOI: 10.3393/jksc.2010.26.3.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | - Jae-Cheol Kim
- Department of Surgery, Hanam Song Do Colorectal Hospital, Hanam, Korea
| | - Jong-Kyun Lee
- Department of Surgery, Song Do Colorectal Hospital, Seoul, Korea
| | - Kwang-Yeon Kim
- Department of Surgery, Song Do Colorectal Hospital, Seoul, Korea
| |
Collapse
|
2
|
Johansen A, Axelsson C. The pathological-anatomical differential diagnosis between morbus Crohn and ulcerative colitis. ACTA PATHOLOGICA ET MICROBIOLOGICA SCANDINAVICA. SECTION A, PATHOLOGY 2009; 78:36-48. [PMID: 5446258 DOI: 10.1111/j.1699-0463.1970.tb02126.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
3
|
Abstract
Inflammatory bowel disease in childhood refers to ulcerative colitis, Crohn's disease, and colitis of an indeterminate type. Their gross and microscopic features are discussed along with the differential diagnosis from other childhood conditions associated with bloody diarrhea.
Collapse
Affiliation(s)
- Terry Gramlich
- AmeriPath's Institute of Gastrointestinal Pathology, Oakwood Village, Ohio 44146, USA.
| | | |
Collapse
|
4
|
Abstract
Lower gastrointestinal (GI) hemorrhage is a significant cause of morbidity and mortality, particularly in elderly patients. Lower endoscopic evaluation is established as the diagnostic procedure of choice in the setting of acute lower GI hemorrhage.
Collapse
Affiliation(s)
- Brenna Casey Bounds
- Harvard Medical School, Gastrointestinal Unit, Massachusetts General Hospital, 55 Fruit Street, Blake 453D, Boston, MA 02114, USA.
| | | |
Collapse
|
5
|
Abstract
Lower gastrointestinal bleeding is defined as blood loss that originates from a source distal to the ligament of Treitz and results in hemodynamic instability or symptomatic anemia. Although approximately 10% to 15% of patients presenting with acute severe hematochezia have an upper gastrointestinal source of bleeding identified on upper endoscopy, the most common causes of lower gastrointestinal bleeding are diverticulosis, hemorrhoids, ischemic colitis, and angiodysplasia. As with upper gastrointestinal bleeding, lower gastrointestinal bleeding ceases spontaneously in most cases.
Collapse
Affiliation(s)
- Brenna Casey Bounds
- Department of Medicine, Harvard Medical School, Gastrointestinal Unit, Massachusetts General Hospital, 55 Fruit Street, Blake 453C, Boston, MA 02114, USA.
| | | |
Collapse
|
6
|
Pardi DS, Loftus EV, Tremaine WJ, Sandborn WJ, Alexander GL, Balm RK, Gostout CJ. Acute major gastrointestinal hemorrhage in inflammatory bowel disease. Gastrointest Endosc 1999; 49:153-7. [PMID: 9925691 DOI: 10.1016/s0016-5107(99)70479-7] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Acute major gastrointestinal hemorrhage is uncommon in inflammatory bowel disease. METHODS We characterized the clinical features and course of such hemorrhage in patients at our institution from 1989 to 1996. RESULTS Thirty-one patients had acute lower gastrointestinal bleeding from inflammatory bowel disease and one had upper gastrointestinal bleeding from duodenal Crohn's disease. Three patients had ulcerative colitis and 28 had Crohn's disease, representing 0.1% of admissions for ulcerative colitis and 1.2% for Crohn's disease. In addition, another patient bled from an ileal J-pouch. In patients with Crohn's disease, the site of bleeding was duodenal in 1, small intestinal in 9, ileocolonic in 8, and colonic in 10. All ulcerative colitis patients had pancolitis. Medical therapy was initiated in 27 patients, including endoscopic therapy in 3. Five patients underwent surgery immediately, and 7 medically treated patients eventually required surgery for ongoing or recurrent bleeding. CONCLUSIONS Acute major gastrointestinal bleeding is uncommon in inflammatory bowel disease. Most cases are due to Crohn's disease, without a predilection for site of involvement. The presence of an endoscopically treatable lesion is uncommon, and surgery is required in less than half of cases during the initial hospitalization. Recurrent hemorrhage is not rare, and for these cases surgery may be the most appropriate treatment.
Collapse
Affiliation(s)
- D S Pardi
- Inflammatory Bowel Disease Clinic and GI Bleeding Team, Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation, Rochester, Minnesota, USA
| | | | | | | | | | | | | |
Collapse
|
7
|
Moses PL, Moore BR, Ferrentino N, Bensen SP, Vecchio JA. Inflammatory bowel disease. 1. Origins, presentation, and course. Postgrad Med 1998; 103:77-84. [PMID: 9590987 DOI: 10.3810/pgm.1998.05.483] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The exact cause of inflammatory bowel disease remains undiscovered, but its destructive nature is clearly recognized. In this article, the authors summarize what is known about the pathogenesis and epidemiology of ulcerative colitis and Crohn's disease and how to distinguish between the two, both clinically and pathologically. They also describe disorders that may mimic inflammatory bowel disease. In part 2 of this article, beginning on page 86, the authors discuss some of the therapeutic options that are the commonly used as well as some that are investigational but show promise for patients with this chronic and relapsing disease.
Collapse
Affiliation(s)
- P L Moses
- Section of Gastroenterology and Hepatology, University of Vermont College of Medicine, Burlington 05405-0068, USA
| | | | | | | | | |
Collapse
|
8
|
Sangwan YP, Schoetz DJ, Murray JJ, Roberts PL, Coller JA. Perianal Crohn's disease. Results of local surgical treatment. Dis Colon Rectum 1996; 39:529-35. [PMID: 8620803 DOI: 10.1007/bf02058706] [Citation(s) in RCA: 104] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE This study relates our experience with local surgical management of perianal Crohn's disease. METHOD Of 1,735 patients with Crohn's disease seen between 1980 and 1990, records of 66 patients (3.8 percent) with symptomatic perianal Crohn's disease treated by local operations were retrospectively reviewed to study outcome of local surgical intervention. RESULTS All patients had intestinal disease that was limited to the colon in 32 patients (48 percent), ileocolonic region in 22 patients (33 percent), and ileum in 12 patients (18 percent). Types of perianal disease encountered included perianal suppuration (57), anal fistula (47), anal fissure (21), anal stenosis (5), gluteal abscess (3), scrotal abscess (2), and anovaginal fistula (2). A total of 321 episodes of anal complications necessitated 256 local surgical interventions. Local anorectal operations performed included simple incision and drainage of abscess (57), fistulotomy (35), incision and drainage of complex anorectal abscesses and fistulas and insertion of seton (24), internal sphincterotomy (6), fissurectomy (1), and anal dilation (3). Of 24 patients with horseshoe abscesses and fistulas managed with insertion of a seton and 35 patients who underwent fistulotomy as a primary procedure or in conjunction with drainage of an abscess, none experienced fecal incontinence as a direct result of the operation. Thirteen patients required proctectomy to control perianal disease, and a similar number underwent total proctocolectomy for extensive intestinal disease. Forty patients (61 percent) continue to retain a functional anus. CONCLUSION Patients with symptomatic low anal fistula involving minimum sphincter musculature can be treated safely with fistulotomy. In treatment of patients with horseshoe abscesses and high fistulas, aggressive local surgical intervention using a seton permits preservation of the sphincter and good postoperative function.
Collapse
Affiliation(s)
- Y P Sangwan
- Department of Colon and Rectal Surgery, Lahey Hitchcock Medical Center, Burlington, Massachusetts, USA
| | | | | | | | | |
Collapse
|
9
|
Longo WE, Oakley JR, Lavery IC, Church JM, Fazio VW. Outcome of ileorectal anastomosis for Crohn's colitis. Dis Colon Rectum 1992; 35:1066-71. [PMID: 1425051 DOI: 10.1007/bf02252997] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
One hundred thirty-one patients underwent ileorectal anastomosis (IRA) for Crohn's colitis. Preoperatively, 84 patients (63 percent) were found to have mild or moderate proctitis and 47 (37 percent) had rectal sparing. Sixty-eight (52 percent) had associated small bowel disease, and 20 (15 percent) had perianal disease. Sixty-five IRAs were performed at the time of subtotal colectomy, while 56 were done after previous surgery. Anastomotic leaks occurred in four patients. There were no operative deaths. Thirteen patients (10 percent) with protecting stomas never underwent closure. Among the remaining 118 patients with functioning IRAs, 30 (23 percent) required later proctectomy and 16 (13 percent) required proximal diversion, with the mean period with a functioning IRA in these 46 patients being 4.1 years (range, 6.2 months-12.7 years). An additional 13 patients required preanastomotic resection and neo-IRA, and 11 required proximal small bowel resection. The mean duration of function of all 118 IRAs was 9.2 years. At the time of review, after a mean follow-up of 9.5 years, 72 patients (61 percent) retained a functioning IRA, with 44 being free of disease, while 28 were being treated with steroids or antidiarrheal medication. The mean stool frequency was 4.7 per day. In patients with Crohn's colitis, IRA should be considered as an alternative to proctocolectomy if the rectum is not severely diseased and sphincter function is not compromised.
Collapse
Affiliation(s)
- W E Longo
- Department of Colorectal Surgery, Cleveland Clinic Foundation, Ohio 44195-5044
| | | | | | | | | |
Collapse
|
10
|
Shivananda S, Hordijk ML, Ten Kate FJ, Probert CS, Mayberry JF. Differential diagnosis of inflammatory bowel disease. A comparison of various diagnostic classifications. Scand J Gastroenterol 1991; 26:167-73. [PMID: 2011704 DOI: 10.3109/00365529109025027] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Fifty consecutive patients with inflammatory bowel disease of the colon who presented at the University Hospital Rotterdam/Dijkzigt were assessed by four methods: clinical diagnosis, criteria defined by Lennard-Jones and by the Organisation Mondiale de Gastroenterologie (O.M.G.E.) scoring systems, and histologic slide review. All cases were classified into three diagnostic groups: established Crohn's disease (CD), indeterminate colitis, or definite ulcerative colitis (UC). The classifications were compared by kappa analysis. Eighteen of the 50 patients were classified as having established CD by the O.M.G.E. scoring system and Lennard-Jones criteria; 17 were so classified by clinicians, and only 8 by histologic slide review. The agreement among clinician's diagnosis, Lennard-Jones criteria, and the O.M.G.E. scoring system was good (Fleiss-Cohen-weighted kappa; p less than 0.001). Agreement among histology, Lennard-Jones criteria, and the O.M.G.E scoring system was less good (p less than 0.05) and not significantly associated with clinical diagnosis. Histology was less prone to diagnose established CD or established UC and more likely to diagnose indeterminate colitis. This study has shown that the systems of disease definition set out by Lennard-Jones and the O.M.G.E. are comparable and agree well with each other and clinicians's diagnosis, but biopsy specimens have a limited diagnostic value in disease differentiation in inflammatory bowel disease.
Collapse
Affiliation(s)
- S Shivananda
- Dept. of Internal Medicine II, University Hospital, Rotterdam/Dijkzigt, The Netherlands
| | | | | | | | | |
Collapse
|
11
|
Leddin DJ, Paterson WG, DaCosta LR, Dinda PK, Depew WT, Markotich J, McKaigney JP, Groll A, Beck IT. Indium-111-labeled autologous leukocyte imaging and fecal excretion. Comparison with conventional methods of assessment of inflammatory bowel disease. Dig Dis Sci 1987; 32:377-87. [PMID: 3829880 DOI: 10.1007/bf01296291] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This study was designed to evaluate the role of 111In-labeled leukocyte imaging and fecal excretion in the assessment of inflammatory bowel disease. We compared these tests to various indices of disease activity in Crohn's disease, to Truelove's grading in ulcerative colitis, and to endoscopy, x-ray, and pathology in both diseases. Eleven controls, 16 patients with Crohn's disease, 13 with ulcerative colitis, and 3 with other types of acute bowel inflammation were studied (positive controls). Indium scanning was performed at 1, 4, and 24 hr. Fourteen of 16 patients with active Crohn's disease had positive scans but in only five was localization accurate. One patient had inactive ulcerative colitis, and the scan was negative. Of 12 patients with active ulcerative colitis, 10 had positive scans but disease localization was accurate in only four. Disease extent was correctly defined in 1 of the 3 Positive Controls. There was no significant difference in the accuracy of scanning at 1, 4, or 24 hr. 111In fecal excretion was significantly higher in patients with inflammatory bowel disease than in controls, and there was correlation between 111In fecal excretion and most of the indices of disease activity in Crohn's disease. In ulcerative colitis, 111In fecal excretion did not correlate with Truelove's grading but reflected colonoscopic assessment of severity. In conclusion, 111In-labeled leukocyte scanning lacks sensitivity with respect to disease extent, but fecal excretion of 111In correlates well with disease severity as determined by other methods.
Collapse
|
12
|
Farmer RG, Whelan G, Fazio VW. Long-term follow-up of patients with Crohn's disease. Relationship between the clinical pattern and prognosis. Gastroenterology 1985; 88:1818-25. [PMID: 3922845 DOI: 10.1016/0016-5085(85)90006-x] [Citation(s) in RCA: 312] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
In a study of 615 new patients with Crohn's disease consecutively diagnosed at the Cleveland Clinic between 1966 and 1969, 592 patients were observed (mean greater than 13 yr, minimum 7 yr), giving a follow-up rate of 96.3%. The original hypothesis was that initial anatomic involvement (the clinical pattern) bears directly on clinical course and prognosis. Disease sites were as follows: 246 ileocolic, 165 small intestine, and 181 colon/anorectal. Among patients with ileocolic disease, 225 (91.5%) had surgery. For the small intestine pattern, the operative incidence was 65.5%; for the colon/anorectal pattern, it was 58%. Operations were for specific reasons: internal fistula with abscess or intestinal obstruction for ileocolic pattern; intestinal obstruction for small intestine pattern; and severe perianal disease or toxic megacolon for colon/anorectal pattern. Complications among nonoperated patients included perianal fistulas and extraintestinal manifestations. No statistical correlation existed between type and duration of medical treatment and prognosis. Seventy-five deaths occurred (12.8%), 36 of which related directly to Crohn's disease. Even after many years, symptoms continued and quality of life tended to be suboptimal among operated patients. For nonoperated patients, the most favorable quality of life was experienced by those with segmental involvement of the colon or ileum. Poor prognosis correlated with ileocolic disease and presence of sepsis because of an internal fistula.
Collapse
|
13
|
Mortensen NJ, Ritchie JK, Hawley PR, Todd IP, Lennard-Jones JE. Surgery for acute Crohn's colitis: results and long term follow-up. Br J Surg 1984; 71:783-4. [PMID: 6487978 DOI: 10.1002/bjs.1800711016] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Acute Crohn's disease of the colon requiring emergency surgery is uncommon, but may be increasing in frequency. Between 1954 and 1981, 215 patients had surgery for acute inflammatory bowel disease at St. Mark's Hospital, and of these 18 had acute Crohn's colitis. There was one postoperative death, and the remaining patients were followed up for an average of 8 years. Ten patients had toxic dilation, two a toxic dilation with free perforation, three had perforation without dilatation and in three surgery was required for an acute deterioration. Surgical treatment included proctocolectomy (one), colectomy and ileostomy (fourteen), colectomy and ileorectal anastomosis (two) and defunctioning ileostomy alone (one). Subsequent rectal excision was necessary in ten of sixteen patients. Acute colonic Crohn's disease requiring surgery is less likely than ulcerative colitis to be amenable to restorative surgery despite a policy of rectal conservation.
Collapse
|
14
|
Abstract
Anal fissures, fistulas, and abscesses occurred as complications in 22 per cent of our population of 1,098 patients with Crohn's disease. Crohn's colitis was much more frequently associated with an anal lesion than Crohn's disease of the small bowel (52 per cent vs. 14 per cent). When an anal lesion is the manifesting sign, Crohn's disease will soon develop elsewhere in the intestine. Since these lesions frequently herald the onset of intestinal Crohn's disease, the physician must always be aware of the possibility of inflammatory bowel disease when dealing with suspicious anal lesions.
Collapse
|
15
|
Price AB. Overlap in the spectrum of non-specific inflammatory bowel disease--'colitis indeterminate'. J Clin Pathol 1978; 31:567-77. [PMID: 670413 PMCID: PMC1145346 DOI: 10.1136/jcp.31.6.567] [Citation(s) in RCA: 301] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
It is stated that 10-20% of cases of non-specific inflammatory bowel disease cannot be classified. Thirty such cases, designated colitis indeterminate at the time of colectomy, were identified from the pathology files of St. Mark's Hospital. The Histopathological features of the surgical specimens and any available biopsy specimens were studied. In nearly all the cases urgent surgery had been required and the features of incipient or established fulminating disease were present. The pathology of these cases of Crohn's disease and ulcerative colitis overlapped, and differentiating features were scant or unreliable. Accepted criteria of Crohn's disease--namely, fissuring ulceration, transmural inflammation, and a maintained goblet-cell population--were found in cases subsequently proved to be ulcerative colitis. Disease activity greatly affected the evaluation of morphological features. Many of the difficulties were resolved when biopsy material obtained during a quiescent phase was examined. The specimens gave a dynamic perspective of the disease process, often more valuable than the static, non-specific picture of acute disease seen in the surgical specimens. Case of colitis indeterminate form a small distinctive group in the spectrum of inflammatory bowel disease which is characterised by a common pattern of pathology that presents a diagnostic dilemma.
Collapse
|
16
|
Abstract
Thirty-seven patients were studied who had an ileorectal anastomosis performed for Crohn's disease of the colon. Twenty-nine were done as a primary procedure and in eight the anastomosis was made after previous total or segmental colectomy. Three patients developed anastomotic leaks and all three patients died. No patient who had a diverting loop ileostomy performed at the time of ileorectal anastomosis developed anastomotic leaks before or after the ileostomy was closed. Of the 37 patients, three died postoperatively and another five have had less than a one year follow-up. Of the remaining 29 patients, 12 (41%) had recurrences in either the rectum or ileum. Half of the recurrences took place five or more years after surgery. Seven of the 12 patients with recurrences have had their anastomoses taken down. When this recurrence rate of 41% is compared with the recurrence of ileitis in patients after total colectomy and ileostomy for Crohn's disease of the colon, the incidence of recurrence is, as shown in many reports, not markedly dissimilar. Of the patients who develop a recurrence after ileorectal anastomosis, only about half will have to have their anastomoses taken down. In our study, 59% of the patients had no recurrence and another 20-5% had a recurrence but did not require 'take down' of the anastomosis. Thus, almost 80% of our patients at the time of this report have been able to lead a life unencumbered by an ileostomy, making ileorectal anastomosis for this disease a desirable procedure to consider in selected patients.
Collapse
|
17
|
Flint GW, Strauss RJ, Platt N, Wise L. Ileorectal anastomosis for inflammatory disease of the colon. Dis Colon Rectum 1977; 20:118-25. [PMID: 844395 DOI: 10.1007/bf02587326] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
We have reported long-term results in the cases of 42 patients following total colectomy and ileorectal anastomosis for inflammatory bowel disease. In this group, 35 patients had Crohn's disease and seven had ulcerative colitis. Five of those seven patients with ulcerative colitis had carcinoma of the colon at the time of colectomy. A diverting loop ileostomy was constructed in 14 of the 35 patients who had Crohn's colitis at the time of operation, and none of these patients had any anastomotic leakage either before or after the ileostomy was closed. However, there patients with Crohn's colitis in whom anastomotic leaks developed postoperatively; all three patients died. In the group with ulcerative colitis, one patient had an anastomotic leak but there was no operative nortality. Of the 29 patients with Crohn's disease followed for one to 18 years, 12 (41 per cent) developed recurrences in the ileum and/or rectum, and seven of these patients had to have their anastomoses taken down.
Collapse
|
18
|
|
19
|
|
20
|
Shorter RG, Shephard DA. Frontiers in inflammatory bowel disease. The proceedings of a conference sponsored by the McReynolds Foundation. Part II. THE AMERICAN JOURNAL OF DIGESTIVE DISEASES 1975; 20:639-70. [PMID: 1146789 DOI: 10.1007/bf01071174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
21
|
Abstract
Crohn's disease is a perplexing disease with a high rate of morbidity and complications. The incidence appears to be increasing. The cause is unknown, and response to medical therapy has been disappointing. Diagnosis may be very difficult and often is delayed. A high proportion of patients eventually require surgery, and an appreciable percentage will have recurrence of disease afterward. The prognosis in terms of responsiveness to medical therapy is believed to be poorer than the prognosis of ulcerative colitis. A national cooperative study to assess drug therapy prospectively is under way.
Collapse
|
22
|
Abstract
Twelve new cases of acute toxic dilatation of the colon in Crohn's colitis treated by total colectomy and ileorectal anastomosis are reported, and criteria for making the diagnosis are given.The complication has occurred in 6% of patients diagnosed as having Crohn's disease of the colon treated at the Gordon Hospital since 1948. The patients have been predominantly young adult females, with a short preoperative history of disease. The sigmoidoscopic appearance of the rectum preoperatively has been no indication of the likelihood of recurrent disease at the anastomosis. Only four patients still have successfully functioning ileorectal anastomoses and four patients have died from the effects of the disease.
Collapse
|
23
|
|
24
|
|
25
|
Tompkins RK, Weinstein MH, Foroozan P, Marx FW, Barker WF. Reappraisal of rectum-retaining operations for ulcerative and granulomatous colitis. Am J Surg 1973; 125:159-64. [PMID: 4687995 DOI: 10.1016/0002-9610(73)90021-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
26
|
Akagi T, Nikkaku T, Motoi M, Ogawa K. Regional enteritis of the cecum--a clinico-pathological study. ACTA PATHOLOGICA JAPONICA 1972; 22:637-47. [PMID: 4679154 DOI: 10.1111/j.1440-1827.1972.tb00753.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
27
|
Farmer RG, Hawk WA, Turnbull RB. Crohn's disease of the duodenum (transmural duodenitis): clinical manifestations. Report of 11 cases. THE AMERICAN JOURNAL OF DIGESTIVE DISEASES 1972; 17:191-8. [PMID: 5023879 DOI: 10.1007/bf02232289] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
28
|
|
29
|
Farmer RG, Hawk WA, Turnbull RB. Carcinoma associated with mucosal ulcerative colitis, and with transmural colitis and enteritis (Crohn's disease). Cancer 1971; 28:289-92. [PMID: 5566351 DOI: 10.1002/1097-0142(197108)28:2<289::aid-cncr2820280205>3.0.co;2-i] [Citation(s) in RCA: 45] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
30
|
|
31
|
|
32
|
|
33
|
Papp JP, Pollard HM. Toxic dilatation of the colon in granulomatous colitis. Report of 2 cases. THE AMERICAN JOURNAL OF DIGESTIVE DISEASES 1970; 15:1105-13. [PMID: 5486195 DOI: 10.1007/bf02232877] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
34
|
Hoffmann DC. Crohn's colitis: a diagnostic dilemma. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY 1970; 40:157-62. [PMID: 5274936 DOI: 10.1111/j.1445-2197.1970.tb04049.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
35
|
|
36
|
Farmer RG, Hawk WA, Turnbull RB. Carcinoma associated with regional enteritis. Report of 2 cases. THE AMERICAN JOURNAL OF DIGESTIVE DISEASES 1970; 15:365-71. [PMID: 5439863 DOI: 10.1007/bf02239295] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
37
|
Glotzer DJ, Gardner RC, Goldman H, Hinrichs HR, Rosen H, Zetzel L. Comparative features and course of ulcerative and granulomatous colitis. N Engl J Med 1970; 282:582-7. [PMID: 5413865 DOI: 10.1056/nejm197003122821102] [Citation(s) in RCA: 79] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
38
|
|
39
|
|