title: Surgical aspects of inflammatory bowel diseases in pediatric and adolescent age groups.
abstract: BACKGROUND
  Inflammatory bowel disease (IBD) is increasingly encountered in children. Early disease is associated with higher complication rate with increased incidence of surgical intervention.
  
  
  METHODS
  From January 2010 to June 2015, 25 patients in the pediatric and adolescent age groups with IBD underwent surgical intervention in our center. They were classified into two groups. Group I included 15 patients with ulcerative colitis where 5 cases had left colon disease underwent left colectomy, while 10 cases had pancolonic disease underwent total colectomy and anal mucosectomy with ileo-anal or ileal pouch-anal anastomosis with covering ileostomy. Group II included 10 cases with Crohn's disease where the indications for surgery were intestinal obstruction in seven cases, fulminant perianal infection with septic shock in one, perianal fistula and ulcers in one, and growth failure due to resistant intestinal fistula in one.
  
  
  RESULTS
  Group I included eight males and seven females; mean age at surgery was 10.6 years. There were postoperative complications in seven cases in the form of pelvic abscess and wound infection in one, wound infection in two, and recurrent pouchitis in four cases. Group II contained eight males and two females; mean age at surgery was 6.6 years. Two cases had recurrent symptoms after stricturoplasty. The mean length of time from diagnosis to surgery was 2.4 years (ranging from 6 to 36 months).
  
  
  CONCLUSIONS
  A multidisciplinary team is mandatory for proper management of IBD cases. The risk of the disease and the expected surgical complications determine the timing of surgical interference.
authors.affiliation: Pediatric surgery department, Ain Shams University, 14 mostafa sadek el-rafeay, Heliopolis, 11361, Cairo, Egypt. khaled.elasmar@med.asu.edu.eg.
authors.forename: Khaled
authors.initials: K
authors.lastname: El-Asmar
authors.affiliation: Pediatric surgery department, Ain Shams University, 14 mostafa sadek el-rafeay, Heliopolis, 11361, Cairo, Egypt. ihab.shaf@gmail.com.
authors.forename: Ehab
authors.initials: E
authors.lastname: El-Shafei
authors.affiliation: Pediatric surgery department, Helwan University, Cairo, Egypt. mtifos@hotmail.com.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Abdel-Latif
authors.affiliation: Pediatric surgery department, Ain Shams University, 14 mostafa sadek el-rafeay, Heliopolis, 11361, Cairo, Egypt. amrabdelhamid@hotmail.com.
authors.forename: Amr
authors.initials: A
authors.lastname: AbouZeid
authors.affiliation: Pediatric surgery department, Ain Shams University, 14 mostafa sadek el-rafeay, Heliopolis, 11361, Cairo, Egypt. mosadelbehery@gmail.com.
authors.forename: Mosad
authors.initials: M
authors.lastname: El-Behery
mesh_terms: D000293:Adolescent; D001003:Anal Canal / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000150:complications / Q000601:surgery*; D039021:Colonic Pouches; D003424:Crohn Disease / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007081:Ileostomy; D007223:Infant; D007413:Intestinal Mucosa / Q000601:surgery; D008297:Male; D010348:Patient Care Team; D016737:Proctocolectomy, Restorative
keywords: Colectomy; Crohn’s disease; Inflammatory bowel disease; Stricturoplasty; Ulcerative colitis