Clinical features of enteric and colo-duodenal fistula in patients with Crohn's disease.

IF 3.4 Q2 GASTROENTEROLOGY & HEPATOLOGY

Intestinal Research Pub Date : 2023-07-01 DOI:10.5217/ir.2022.00125

Jun Su Lee, Sang-Bum Kang, Kwangbeom Park, Yong Sik Yoon, Chang Sik Yu, Sung Wook Hwang, Byong Duk Ye, Suk-Kyun Yang, Jong Lyul Lee, Sang Hyoung Park

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Abstract

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 406 resection for management of CD. Usually, ECDF originates from diseased small and large intestines, not the duodenum. The common symptoms of ECDF are abdominal pain, diarrhea, and weight loss. However, these symptoms are difficult to distinguish from the symptoms of active CD, which makes early detection of ECDF difficult. The high intraluminal pressure found in the large intestine than in the duodenum in ECDF, colonic contents can flow back to the duodenum, but pylorus acts as a barrier to the reflux of the contents. Therefore, fecal vomiting is a pathognomonic symptom but very rare, occurring in only 0.5% to 2% of the cases. Further, ECDF is diagnosed by clinical manifestation, radiologic images, endoscopy, and intraoperative findings. Among them, contrast radiography is the most sensitive diagnostic tool, and barium enema is more susceptible than barium meal. Further, surgery is the most common ECDF treatment; no case has been reported to be cured with medical treatment, including with infliximab, which exhibits good effects on perianal fistulizing CD. In addition, surgery after failed biologic treatment increases postoperative complications in patients with CD. For these reasons, surgical treatment for ECDF is preferred even in the biologic era. However, since ECDF cases are rare, and surgery is not easy, the appropriate diagnostic approach and treatment for ECDF are controversial. Also, outcomes and long-term follow-up data of ECDF are not known. Therefore, we sought to investigate the clinical features of ECDF in patients with CD in Korea. We investigated all the CD patients with ECDF in a large tertiary hospital (Asan Medical Center, Seoul, Korea) between pISSN 1598-9100 • eISSN 2288-1956 https://doi.org/10.5217/ir.2022.00125 Intest Res 2023;21(3):406-410

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克罗恩病患者肠道及结肠十二指肠瘘的临床特点。

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来源期刊

Intestinal Research GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.40

自引率

10.20%

发文量

审稿时长

38 weeks

期刊介绍： Intestinal Research (Intest Res) is the joint official publication of the Asian Organization for Crohn''s and Colitis (AOCC), Chinese Society of IBD (CSIBD), Japanese Society for IBD (JSIBD), Korean Association for the Study of Intestinal Diseases (KASID), Taiwan Society of IBD (TSIBD) and Colitis Crohn''s Foundation (India) (CCF, india). The aim of the Journal is to provide broad and in-depth analysis of intestinal diseases, especially inflammatory bowel disease, which shows increasing tendency and significance. As a Journal specialized in clinical and translational research in gastroenterology, it encompasses multiple aspects of diseases originated from the small and large intestines. The Journal also seeks to propagate and exchange useful innovations, both in ideas and in practice, within the research community. As a mode of scholarly communication, it encourages scientific investigation through the rigorous peer-review system and constitutes a qualified and continual platform for sharing studies of researchers and practitioners. Specifically, the Journal presents up-to-date coverage of medical researches on the physiology, epidemiology, pathophysiology, clinical presentations, and therapeutic interventions of the intestinal diseases. General topics of interest include inflammatory bowel disease, colon and small intestine cancer or polyp, endoscopy, irritable bowel syndrome and other motility disorders, infectious enterocolitis, intestinal tuberculosis, and so forth. The Journal publishes diverse types of academic materials such as editorials, clinical and basic reviews, original articles, case reports, letters to the editor, brief communications, perspective, statement or commentary, and images that are useful to clinicians and researchers.