Abstract
Crohn’s colitis affects about 15% of Crohn’s patients and is confined to any segment of the colon between the cecum and rectum. It presents with a bimodal age distribution, the first and most common between ages 15 and 30 and second between 55 and 80 years. Clinical manifestations include abdominal pain, diarrhea, weight loss, and fevers. Macroscopic features include a thickened colon wall, aphthous ulcers, cobblestone appearance of the mucosa, mesenteric fat creeping, and presence of strictures and fistulae. Microscopically they present with focal full-thickness inflammation, mucosal ulceration, and lymphocytic proliferation that can lead to granulomas. Diagnosis is established with a combination of endoscopic and radiologic findings as well as laboratory markers. Medical management consists of antibiotics, sulfa drugs, steroids, immunomodulators, or biologic therapy. Surgery is not curative and therefore should only be considered in patients who fail medical management and develop complications such as stricture, perforation or symptomatic fistulizing disease, and dysplasia or malignancy.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Silverberg MS, Satsangi J, Ahmad T, Arnott ID, Bernstein CN, Brant SR, et al. Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology. Can J Gastroenterol = Journal canadien de gastroenterologie. 2005;19(Suppl A):5a–36a.
Parkes GC, Whelan K, Lindsay JO. Smoking in inflammatory bowel disease: impact on disease course and insights into the aetiology of its effect. J Crohns Colitis. 2014;8(8):717–25.
Smids C, Horjus Talabur Horje CS, Groenen MJM, van Koolwijk EHM, Wahab PJ, van Lochem EG. The value of serum antibodies in differentiating inflammatory bowel disease, predicting disease activity and disease course in the newly diagnosed patient. Scand J Gastroenterol. 2017;52(10):1104–12.
Khanna R, Bressler B, Levesque BG, Zou G, Stitt LW, Greenberg GR, et al. Early combined immunosuppression for the management of Crohn’s disease (REACT): a cluster randomised controlled trial. Lancet. 2015;386(10006):1825–34.
Toh JW, Stewart P, Rickard MJ, Leong R, Wang N, Young CJ. Indications and surgical options for small bowel, large bowel and perianal Crohn’s disease. World J Gastroenterol. 2016;22(40):8892–904.
Strong S, Steele SR, Boutrous M, Bordineau L, Chun J, Stewart DB, et al. Clinical practice guideline for the surgical management of Crohn’s disease. Dis Colon Rectum. 2015;58(11):1021–36.
Strong SA. Management of acute colitis and toxic megacolon. Clin Colon Rectal Surg. 2010;23(4):274–84.
Andrew RE, Messaris E. Update on medical and surgical options for patients with acute severe ulcerative colitis: what is new? World J Gastrointest Surg. 2016;8(9):598–605.
Narula N, Marshall JK, Colombel JF, Leontiadis GI, Williams JG, Muqtadir Z, et al. Systematic review and meta-analysis: infliximab or cyclosporine as rescue therapy in patients with severe ulcerative colitis refractory to steroids. Am J Gastroenterol. 2016;111(4):477–91.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Michailidou, M., Messaris, E. (2019). Crohn’s Colitis. In: Docimo Jr., S., Pauli, E. (eds) Clinical Algorithms in General Surgery . Springer, Cham. https://doi.org/10.1007/978-3-319-98497-1_61
Download citation
DOI: https://doi.org/10.1007/978-3-319-98497-1_61
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-98496-4
Online ISBN: 978-3-319-98497-1
eBook Packages: MedicineMedicine (R0)