{"title":"Nonfistulizing Perianal Crohn's Disease","authors":"Emily Simon, Emily Steinhagen","doi":"10.1055/s-0044-1786198","DOIUrl":"https://doi.org/10.1055/s-0044-1786198","url":null,"abstract":"<p>Perianal Crohn's disease (CD) includes a wide range of nonfistulizing sequela, including fissures and ulcers, skin tags, anal stricture, and anal cancer. Symptoms related to perianal manifestations of CD are often disabling and have a significant impact on patients' quality of life. They include pain, drainage, bleeding, difficulty with hygiene and may cause secondary difficulties with sexual and defecatory dysfunction. The care of patients with perianal CD requires a thoughtful approach, including detailed history taking, physical examination, and often multidisciplinary care teams to maximize quality of life and ameliorate symptoms.</p> ","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"27 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140625964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Management of Severe Colitis and Toxic Megacolon","authors":"Marjorie R. Liggett, Hasan B. Alam","doi":"10.1055/s-0043-1777665","DOIUrl":"https://doi.org/10.1055/s-0043-1777665","url":null,"abstract":"<p>Severe colitis is a well-defined condition encompassing several etiologies but is most often caused by severe ulcerative colitis or <i>Clostridioides difficile</i> infection. Severe colitis can evolve into toxic colitis, or toxic megacolon when associated with bowel dilation and systemic manifestations, resulting in a life-threatening scenario where multidisciplinary management is often required. Medical management continues to play an important role in the initial treatment of toxic megacolon. However, timely surgical intervention can be lifesaving.</p> ","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"13 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139068794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Large Bowel Obstruction: Etiologies, Diagnosis, and Management","authors":"Kevin A. Chen, Muneera R. Kapadia","doi":"10.1055/s-0043-1777452","DOIUrl":"https://doi.org/10.1055/s-0043-1777452","url":null,"abstract":"<p>Large bowel obstructions (LBOs) often require urgent surgical intervention. Diagnosis relies on astute history and physical examination, as well as imaging with computed tomography (CT) scan for stable patients. Because of the high mortality associated with colonic perforation in patients with LBOs, decisive surgical decision-making is needed for optimal outcomes. This review seeks to provide an overview of the etiologies of LBO, diagnosis, and general management principles, as well as specific management for the most common etiologies, including colorectal cancer and strictures.</p> ","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"45 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139068682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Management of Acute Hemorrhoidal Crisis: Evaluation, Treatment, and Special Considerations","authors":"Ayman Khan, Arielle E. Kanters","doi":"10.1055/s-0043-1777663","DOIUrl":"https://doi.org/10.1055/s-0043-1777663","url":null,"abstract":"<p>Hemorrhoidal disease is one of most common pathologies seen by colorectal and general surgeons. Although hemorrhoids themselves are a normal anatomic occurrence, development of symptomatic disease, usually due to bleeding, prolapse, or thrombosis, can cause significant patient distress. Acute presentation related to significant thrombosis or bleeding is referred to as acute hemorrhoidal crisis. Management of this pathology varies from nonoperative intervention for symptom control to definitive incisional or excisional hemorrhoidectomy. Here we will explore the approach to evaluating and treating acute hemorrhoidal crises.</p> ","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"164 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139069088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Colonic Volvulus","authors":"Samantha L. Savitch, Calista M. Harbaugh","doi":"10.1055/s-0043-1777664","DOIUrl":"https://doi.org/10.1055/s-0043-1777664","url":null,"abstract":"<p>Colonic volvulus represents 10 to 15% of all large bowel obstructions in the United States. It most commonly occurs in the sigmoid colon or cecum. Morbidity and mortality from colonic volvulus are high. It is therefore essential to have a high level of suspicion based on presentation and expedient diagnosis and management to prevent progression to ischemia or perforation. Broad goals of management include evaluation of colon viability, relief of obstruction, and prevention of recurrence. Endoscopic and surgical approaches vary based on the site of volvulus, presence of ischemia or perforation, and patient characteristics. This review outlines the epidemiology, presentation, diagnosis, and management of colonic volvulus. A contemporary diagnostic and treatment algorithm is included.</p> ","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"72 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139068782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation and Management of Traumatic Rectal Injury","authors":"Nina M. Clark, Rebecca G. Maine","doi":"10.1055/s-0043-1777666","DOIUrl":"https://doi.org/10.1055/s-0043-1777666","url":null,"abstract":"Abstract Traumatic injury to the rectum is rare but associated with high morbidity and mortality. In recent years, diagnostic and treatment recommendations for these complex injuries have changed. While rare, it is critical for general surgeons to understand the basic principles of injury assessment, damage control, and definitive management of traumatic rectal injuries. This article reviews the literature regarding the evaluation and management of traumatic rectal injuries.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"55 46","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138949417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Blunt and Penetrating Injury to the Bowel: A Review","authors":"Graham Skelhorne-Gross, James Kenny","doi":"10.1055/s-0043-1777668","DOIUrl":"https://doi.org/10.1055/s-0043-1777668","url":null,"abstract":"<p>Traumatic injuries to the small and large bowel are common and can be highly morbid. Identifying these injuries, especially in stable patients who suffer blunt trauma, can be challenging. It is critical that traumatic bowel injuries are diagnosed in a timely fashion as delays in diagnosis and treatment are associated with worse outcomes. The literature outlining the management of traumatic bowel injuries is mostly comprised of retrospective data and case reports/series. We have compiled the existing literature and relevant guidelines into a single resource for providers who care for traumatically injured patients.</p> ","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"27 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138825981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christopher O. Audu, David W. Schechtman, Frank M. Davis
{"title":"Mesenteric Ischemia","authors":"Christopher O. Audu, David W. Schechtman, Frank M. Davis","doi":"10.1055/s-0043-1777667","DOIUrl":"https://doi.org/10.1055/s-0043-1777667","url":null,"abstract":"<p>Mesenteric ischemia occurs when perfusion of the visceral organs fails to meet normal metabolic requirements and subsequently results in abdominal symptoms such as diffuse postprandial pain, peritonitis, food fear, and weight loss. While generally divided into acute and chronic manifestations, mesenteric ischemia is commonly misdiagnosed at initial presentation due to the significant overlap with symptoms of other abdominal pathologies. Prompt recognition and diagnosis, mesenteric revascularization, and critical care management remain the mainstay of treatment in these patients for optimal outcomes. This review will highlight acute versus chronic mesenteric ischemia, their etiology, diagnostic criteria, treatment options, and will emphasize the joint role of the gastrointestinal and vascular surgeon in the timely management of this condition to prevent devastating outcomes.</p> ","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"188 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138687560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sonia Wu, Maher Al Khaldi, Carole S. Richard, François Dagbert
{"title":"Diverticulitis: A Review of Current and Emerging Practice-Changing Evidence","authors":"Sonia Wu, Maher Al Khaldi, Carole S. Richard, François Dagbert","doi":"10.1055/s-0043-1777439","DOIUrl":"https://doi.org/10.1055/s-0043-1777439","url":null,"abstract":"<p>Acute diverticulitis represents a common colorectal emergency seen in the Western world. Over time, management of this condition has evolved. This review aims to highlight recent evidence and update current recommendations. Notable evidence has emerged in certain aspects of diverticulitis. This includes disease pathogenesis, as emerging data suggest a potentially greater role for the microbiome and genetic predisposition than previously thought. Acute management has also seen major shifts, where traditional antibiotic treatment may no longer be necessary for acute uncomplicated diverticulitis. Following successful medical management of acute diverticulitis, indications for elective sigmoidectomy have decreased. The benefit of emergency surgery remains for peritonitis, sepsis, obstruction, and acute diverticulitis in certain immunocompromised patients. Routine colonoscopy, once recommended after all acute diverticulitis episodes, has been shown to be beneficial for cancer exclusion in a distinct patient population. Despite advances in research, certain entities remain poorly understood, such as smoldering diverticulitis and symptomatic uncomplicated diverticular disease. As research in the field expands, paradigm shifts will shape our understanding of diverticulitis, influencing how clinicians approach management and educate patients.</p> ","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"153 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138632200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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