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MINERVA GASTROENTEROLOGICA E DIETOLOGICA

A Journal on Gastroenterology, Nutrition and Dietetics


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Minerva Gastroenterologica e Dietologica 2012 June;58(2):123-35

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: English

Diagnosis and management of Crohn’s disease of the ileal pouch

Li Y. 1, 2, Zhu H. 2, Shen B. 2

1 Department of Gastroenterology, Peking Union Medical College Hospital, Beijing, China; 2 Department of Gastroenterology/Hepatology, The Cleveland Clinic Foundation, Cleveland, OH, USA


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Approximately 20-30% of patients with ulcerative colitis would eventually require surgery despite recent advances in medical therapy. Ileal pouch-anal anastomosis has become the surgical treatment of choice after total proctocolectomy. A subset of patients who had a preoperative diagnosis of ulcerative colitis may develop Crohn’s disease or a Crohn’s disease-like condition of the ileal pouch after surgery. Diagnosis, differential diagnosis, and management of Crohn’s disease of the ileal pouch have been challenging. A combined approach with the assessment of clinical history, endoscopy, histology, abdominal/pelvic imaging, and examination under anesthesia is necessary for an accurate diagnosis, disease classification, management and improvement in outcome. A multidisciplinary approach with gastroenterologists, colorectal surgeons, gastrointestinal pathologists and radiologists for proper medical, endoscopic, and surgical treatment is advocated.

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shenb@ccf.org