Enteral Feeding Devices and Ostomies
Fig. 45.1 Typical initial PEG/PRG tube with internal “bumper” and external “crossbar” When a G-tube is placed surgically, the type of initial tube can vary from a standard mushroom-type tube…
Endoscopy and Inflammatory Bowel Disease
High risk of bacteremia High risk of infection unrelated to bacteremia Low risk of infection Dilatation of esophageal stricture Endoscopic ultrasound with fine-needle aspiration (EUS-FNA) Routine EGD, IC, or sigmoidoscopy…
Radiologic Evaluation of Pediatric Inflammatory Bowel Disease
Fig. 20.1 Compression view of the right lower quadrant from SBFT demonstrates a long segment of narrowed, ulcerated, and nodular-appearing ileum giving the characteristic “cobblestone” appearance (arrows). Loop separation caused…
Quality Improvement in Inflammatory Bowel Disease
Fig. 56.1 Variation in care. (a) Improving quality by decreasing variation. (b) Improving quality by shifting distribution Variation in care has been demonstrated in pediatric IBD [10–12]. In one study,…
Liver Disease in Pediatric Inflammatory Bowel Disease
Hepatobiliary disease Ulcerative colitis Crohn disease Primary sclerosing cholangitis (PSC) ++ + Autoimmune hepatitis (AIH) ++ ++ Autoimmune sclerosing cholangitis (ASC) ++ + IgG4-associated cholangitis (IAC) ++ + Cholelithiasis −…
Surgical Treatment of Ulcerative Colitis
Urgent/emergent indications Intractable bleeding Unrelenting pain Unremitting sepsis Complications Colonic perforation Colonic stricture Elective indications Refractory to or complications of medical management Chronic malnutrition Poor growth Delayed sexual maturation Steroid…
Management of Intra-abdominal Complications of Inflammatory Bowel Disease
Fig. 40.1 Proposed mechanism of pathogenesis of internal penetrating Crohn disease (Adapted from Pfefferkorn et al. [2]) Evaluation The most common presenting symptoms and signs in patients with internal penetrating…
Postoperative Surveillance and Management of Crohn’s Disease
Fig. 43.1 The natural course of postoperative Crohn’s disease Postoperative Crohn’s disease recurrence is often clinically silent. Rutgeerts and colleagues found in their initial seminal study of the natural history…
Clinical Indices for Pediatric Inflammatory Bowel Disease Research
Instrument items CDAI [13] HBI [18] Clinical signs and symptoms Stools Abdominal pain General well-being No. of complications Sum of liquid/soft stools (× 2) Sum of daily score of 0–3…
Pouchitis After Ileal Pouch-Anal Anastomosis
Fig. 44.1 (a) Schematic drawing of constructed “J”-pouch (left) and “S”-pouch (right). (b) Normal-appearing J-pouch with efferent (top) and afferent (bottom) giving “owl’s eye” appearance. (c) Inflamed pouch with diffuse…
