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Pitfalls in Diagnosis of Early-Onset Inflammatory Bowel Disease
| Content Provider | Scilit |
|---|---|
| Author | Junco, Paloma Triana Galán, Alba Sánchez Prieto, Gerardo Ramos, Esther Romo, Martha Muñoz Cervantes, Manuel Gómez Hernández, Francisco Martínez, Leopoldo Santamaría, Manuel López Dore, Mariela |
| Copyright Year | 2017 |
| Description | Aim The onset of inflammatory bowel disease (IBD) in patients younger than the age of 5 years is rare. Moreover, when there is exclusive colonic inflammation, diagnosis can be challenging. Our aim was to describe the difficulties and pitfalls in the diagnosis of early-onset IBD (eoIBD) and their repercussions in treatment decisions. Patients and Methods Patients with eoIBD (Crohn's disease [CD], ulcerative, and unclassified colitis) treated at our center between 1990 and 2016 were studied retrospectively. Demographic, clinical, medical, and surgical treatment data were analyzed. Results A total of 19 patients were diagnosed with eoIBD at 21 (1–46) months of age. Bloody diarrhea, growth failure, and abdominal pain were present in 90, 42, and 16%, respectively. After 9 (1–62) months from the onset, patients were classified as ulcerative colitis (nine), CD (two), and unclassified colitis (eight). Unresponsiveness to medical treatment was observed in 10 and prompted surgical assessment. A partial colectomy was performed in one, and nine underwent a total colectomy (one end stoma and eight ileoanal anastomosis [IAA]). At least one surgical complication occurred in 80% and ultimately six patients with an IAA required an end stoma. Overtime, final diagnosis of 5 out of the 10 surgical patients changed due to biopsy findings, unresponsiveness to medical treatment, or extraintestinal and perianal manifestations. After a 12-year (1–22) follow-up, 57.9% of the diagnoses of all patients were modified. Conclusion EoIBD poses a challenge due to ambiguous presentation and absence of specific diagnostic tests. Surgical evaluation is often needed and surgeons must be mindful of possible initial misdiagnosis, in addition to short- and long-term outcomes before deciding aggressive surgical measures as well as intestinal reconstruction. |
| Related Links | http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0037-1604428.pdf |
| Ending Page | 043 |
| Page Count | 5 |
| Starting Page | 039 |
| ISSN | 09397248 |
| e-ISSN | 1439359X |
| DOI | 10.1055/s-0037-1604428 |
| Journal | European Journal of Pediatric Surgery |
| Issue Number | 01 |
| Volume Number | 28 |
| Language | English |
| Publisher | Georg Thieme Verlag KG |
| Publisher Date | 2017-07-25 |
| Access Restriction | Open |
| Subject Keyword | Journal: European Journal of Pediatric Surgery Gastroenterology and Hepatology Inflammatory Bowel Disease Early Onset Surgical Assessment Ulcerative Colitis Crohn's Disease |
| Content Type | Text |
| Resource Type | Article |
| Subject | Surgery Pediatrics, Perinatology and Child Health |
