Diagnosis and management of Crohn's disease of the ileal pouch.
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.
Department of Gastroenterology, Peking Union Medical College, Beijing, China.
Y
Y
Li
H
H
Zhu
B
B
Shen
D000465:Algorithms; D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches; D003424:Crohn Disease / Q000175:diagnosis* / Q000628:therapy*; D003937:Diagnosis, Differential; D006801:Humans; D011183:Postoperative Complications / Q000175:diagnosis*