Angiodysplasia is primarily a disease of the elderly, and it is rarely encountered in the pediatric population. We report a case of diffuse colorectal angiodysplasia, diagnosed postoperatively in a 13-year-old boy who underwent hand-assisted laparoscopic total proctocolectomy and ileal pouch anal anastomosis (IPAA) for assumed corticosteroid-resistant ulcerative colitis. The findings of preoperative repeated colonoscopies and biopsies had been consistent with active colitis. Distinguishing ulcerative colitis from angiodysplasia is not usually difficult in patients with rectal bleeding. To our knowledge, this is the fi rst case report of such a challenging diagnostic problem.
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http://dx.doi.org/10.1007/s00595-007-3698-y | DOI Listing |
Dig Dis Sci
January 2025
Department of Gastroenterology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, 260-8670, Japan.
Purpose: The performance of endoscopic evaluation of ulcerative colitis (UC) using conventional scoring, including Mayo endoscopic subscore (MES) and ulcerative colitis endoscopic index of severity (UCEIS), is not satisfactory. Recently, the usefulness of novel image-enhanced endoscopy (IEE) such as texture and color enhancement imaging (TXI) and red dichromatic imaging (RDI) has been reported in the endoscopic evaluation of UC. We evaluated the performance of IEEs in UC, particularly focusing on the correlation with MES and UCEIS, and prediction of relapse.
View Article and Find Full Text PDFInn Med (Heidelb)
January 2025
Lehrstuhl für Ernährung und Immunologie, School of Life Sciences, Technische Universität München, Gregor-Mendel-Straße 2, 85354, Freising, Deutschland.
Background: The intestinal microbiota comprises all living microorganisms in the gastrointestinal tract and is crucial for its function. Clinical observations and laboratory findings confirm a central role of the microbiota in chronic inflammatory bowel diseases (IBD). However, many mechanistic details remain unclear.
View Article and Find Full Text PDFAnnu Rev Med
January 2025
Department of Medicine, University of California San Diego, La Jolla, California, USA.
Chronic pouchitis (CP) occurs in approximately 20% of patients with ulcerative colitis after total proctocolectomy with ileal pouch anal anastomosis and is categorized as antibiotic dependent, antibiotic refractory, or Crohn's disease-like. The management of CP is challenging because of limited evidence and few randomized controlled trials. In this review, we discuss the medical management of CP and its supporting data delineated by type of therapy.
View Article and Find Full Text PDFDig Dis Sci
January 2025
INFINY Institute, Department of Gastroenterology, CHRU Nancy, INSERM NGERE, Université de Lorraine, 54500 , Vandœuvre-lès-Nancy, France.
Background: Therapeutic drug monitoring is important for optimizing anti-tumor necrosis factor-α (TNF-α) therapy in inflammatory bowel disease. However, the exposure-response relationship has never been assessed in pouchitis.
Aims: To explore associations between anti-TNF-α drug concentration and pouchitis disease activity in patients with a background of ulcerative colitis.
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