[Pediatric Crohn's disease complications].
This case report describes our experience in treatment of a child with Crohn's disease involvement of ileocecal and sigmoid regions complicated with a severe abdominal wall abscess. A combined therapeutic approach of the acute episode was based on intestinal diversion, abscess drainage, antibiotherapy, nutritional support and post-operative immunosuppression with azathioprine. The definitive treatment of the ileocolonic involvement occurred 6 months after the acute episode and consisted of limited resection, multiple strictureplasties, primar" closure of ileosigmod fistula and undiversion. This operative procedure was followed by a short period of total parenteral nutrition and progressive re-establishment ofenteric nutritional support and immunosuppression. At 18 months follow-up, under low dose azathioprine revealed, a normal growth with a 20 Kg weight gain and 10 cm height gain, no evidence of fistula recurrence or restenosis and suggests the safety of strictureplasty in paediatric patients as a way to conserve as much small bowel as possible.
Casella
P
P
Departamento de Cirurgia, Hospital Dona Estefânia, Lisboa.
Alves
F
F
Cabral
J
J
D018784:Abdominal Abscess / Q000150:complications / Q000601:surgery / Q000628:therapy; D000293:Adolescent; D001379:Azathioprine / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003424:Crohn Disease / Q000150:complications* / Q000601:surgery / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D010289:Parenteral Nutrition, Total
D007166:Immunosuppressive Agents; D001379:Azathioprine
Doença de Crohn complicada em idade pediátrica.