Surgical tactics for Crohn’s disease complicated by intestinal bleeding

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

BACKGROUND: The course of Crohn’s disease often leads to complications requiring surgical treatment. One of the most serious complications of Crohn’s disease is intestinal bleeding.

AIM: To determine the most optimal timing and extent of surgical treatment in patients with Crohn’s disease complicated by intestinal bleeding when conservative therapy is ineffective.

MATERIALS AND METHODS: The article presents the experience of treating patients with Crohn’s disease complicated by intestinal bleeding at the Center for Gastroenterology and Oncopreventology of the Elizabeth Hospital (Russia) and the Republican Scientific Center of Coloproctology (Uzbekistan).

RESULTS: Despite the possibilities of conservative treatment, in 33% of cases the therapy was ineffective and required urgent surgical intervention. The degree of intervention was selected individually based on multivariate analysis.

CONCLUSIONS: Intestinal bleeding is a life-threatening complication of Crohn’s disease, causing the need for surgical intervention in almost a third of cases. Crohn’s disease is characterized by various damage to the gastrointestinal tract, which require multiple options for resective surgery on the small and large intestines, as well as an individual approach to the degree of intervention. The use of modern methods of complex conservative therapy for Crohn’s disease can reduce the risk of complications and reduce the amount of surgical intervention.

About the authors

Evgeniy M. Trunin

North-Western State Medical University named after I.I. Mechnikov

Email: Evgeniy.Trunin@szgmu.ru
ORCID iD: 0000-0002-2452-0321
SPIN-code: 5903-0288

MD, Dr. Sci. (Med.), Professor

Russian Federation, Saint Petersburg

Sergey V. Petrov

North-Western State Medical University named after I.I. Mechnikov; City Hospital of the Holy Martyr Elizabeth

Email: petrovsv@eliz-spb.ru
ORCID iD: 0009-0006-5578-3913
SPIN-code: 8151-2024

MD, Dr. Sci. (Med.), Professor

Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015; Saint Petersburg

Andrey I. Shchegolev

North-Western State Medical University named after I.I. Mechnikov; City Hospital of the Holy Martyr Elizabeth

Email: cionic@yandex.ru
ORCID iD: 0000-0003-1563-2126

MD, Cand. Sci. (Med.)

Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015; Saint Petersburg

Aleksandr A. Kozobin

North-Western State Medical University named after I.I. Mechnikov; City Hospital of the Holy Martyr Elizabeth

Email: akozobin@mail.ru
ORCID iD: 0000-0003-1527-3848

MD, Cand. Sci. (Med.)

Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015; Saint Petersburg

Vladislav V. Tatarkin

North-Western State Medical University named after I.I. Mechnikov

Email: Vladislav.Tatarkin@szgmu.ru
ORCID iD: 0000-0002-9599-3935

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Anton V. Koshcheev

North-Western State Medical University named after I.I. Mechnikov; City Hospital of the Holy Martyr Elizabeth

Author for correspondence.
Email: kosheev70@yandex.ru
ORCID iD: 0000-0003-1803-5298

MD, Cand. Sci. (Med.)

Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015; Saint Petersburg

Sayfiddin R. Baymakov

Tashkent State Dental Institute

Email: bsayfiddin@yahoo.com
ORCID iD: 0000-0003-1096-835X

MD, Dr. Sci. (Med.), Professor

Uzbekistan, Tashkent

Sherkabul B. Tagayev

Tashkent State Dental Institute

Email: tagayev.66@mail.ru
ORCID iD: 0009-0004-7661-9253

MD, Dr. Sci. (Med.), Assistant Professor

Uzbekistan, Tashkent

Mirkhokim M. Pulatov

Tashkent State Dental Institute

Email: mir181164@gmail.com
ORCID iD: 0000-0001-6767-7241

MD, Cand. Sci. (Med.), Assistant Professor

Uzbekistan, Tashkent

References

  1. Sandborn WJ, Feagan BG, Hanauer SB, et al. A review of activity indices and efficacy endpoints for clinical trials of medical therapy in adults with Crohn’s disease. Gastroenterology. 2002;122:512–530. doi: 10.1053/gast.2002.31072
  2. Ivashkin VT, Shelygin YuA, Baranskaya YeK, et al. Diagnosis and treatment of the irritable bowel syndrome: clinical guidelines of the Russian gastroenterological association and Russian association of coloproctology. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2017;27(5):76–93. EDN: ZHQRZJ doi: 10.22416/1382-4376-2017-27-5-76-93
  3. Ng SC, Kamm MA. Management of postoperative Crohn’s disease. Am J Gastroenterol. 2008;103(4):1029–1035. doi: 10.1111/j.1572-0241.2008.01795.x
  4. Vorob’ev GI, Khalif IL. Nonspecific inflammatory bowel diseases. Moscow: Miklosh; 2008. 424 p. (In Russ.)
  5. Kim KJ, Han BJ, Yang SK, et al. Risk factors and outcome of acute severe lower gastrointestinal bleeding in Crohn’s disease. Dig Liver Dis. 2012;44(9):723–728. doi: 10.1016/j.dld.2012.03.010
  6. Strong S, Steele SR, Boutrous M, et al. Clinical Practice Guideline for the Surgical Management of Crohn’s disease. Dis Colon Rectum. 2015;58(11):1021–1036. doi: 10.1097/DCR.0000000000000450
  7. Goldstone RN, Steinhagen RM. Abdominal emergencies in inflammatory bowel disease. Surg Clin North Am. 2019;99(6):1141–1150. doi: 10.1016/j.suc.2019.08.007
  8. Atroshchenko AO, Kolygin AV, Severova MM, Markushin LI. Crohn’s disease manifested with massive colonic bleeding (review and a clinical case). Koloproktologia. 2021;20(3):84–94. EDN: KCGLQS doi: 10.33878/2073-7556-2021-20-3-84-94

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2024 Eco-Vector



Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).