title: Surgical strategies in paediatric inflammatory bowel disease.
abstract: Inflammatory bowel disease (IBD) comprises two distinct but related chronic relapsing inflammatory conditions affecting different parts of the gastrointestinal tract. Crohn's disease is characterised by a patchy transmural inflammation affecting both small and large bowel segments with several distinct phenotypic presentations. Ulcerative colitis classically presents as mucosal inflammation of the rectosigmoid (distal colitis), variably extending in a contiguous manner more proximally through the colon but not beyond the caecum (pancolitis). This article highlights aspects of the presentation, diagnosis, and management of IBD that have relevance for paediatric practice with particular emphasis on surgical considerations. Since 25% of IBD cases present in childhood or teenage years, the unique considerations and challenges of paediatric management should be widely appreciated. Conversely, we argue that the organizational separation of the paediatric and adult healthcare worlds has often resulted in late adoption of new approaches particularly in paediatric surgical practice.
authors.affiliation: Colin T Baillie, Jennifer A Smith, Department of Paediatric Surgery, Royal Liverpool Childrens Hospital, NHS Trust, Liverpool L12 2AP, United Kingdom.
authors.forename: Colin T
authors.initials: CT
authors.lastname: Baillie
authors.affiliation: Colin T Baillie, Jennifer A Smith, Department of Paediatric Surgery, Royal Liverpool Childrens Hospital, NHS Trust, Liverpool L12 2AP, United Kingdom.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D003424:Crohn Disease / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015994:Incidence; D012307:Risk Factors; D060305:Transition to Adult Care; D016896:Treatment Outcome
keywords: Crohn's disease; Inflammatory bowel disease; Paediatric; Surgery; Ulcerative colitis