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. 2021 Apr;36(4):709-715.
doi: 10.1007/s00384-020-03783-9. Epub 2020 Oct 21.

Postoperative diagnostic revision for Crohn disease after subtotal colectomy for inflammatory bowel disease

Hélène Hermand  1 , Jérémie H Lefèvre  2 , Conor Shields  1   3 , Najim Chafai  1 , Clotilde Debove  1 , Laurent Beaugerie  4 , Magali Svrcek  5 , Yann Parc  1 ; Saint-Antoine IBD Network
Affiliations

Postoperative diagnostic revision for Crohn disease after subtotal colectomy for inflammatory bowel disease

Hélène Hermand et al. Int J Colorectal Dis. 2021 Apr.

Abstract

Purpose: Subtotal colectomy (STC) is performed for severe acute and refractory colitis. The diagnosis can be difficult even after the surgery when colectomy specimen has overlapping features of ulcerative colitis (UC) and Crohn's disease (CD). The aim of this study was to evaluate the rate of postoperative diagnostic revision to CD after surgery and determine predictor factors.

Methods: Retrospective study of 110 patients who underwent STC (2005-2018).

Results: Preoperative diagnosis comprised UC = 80 (73%), CD = 11 (10%), and unclassified colitis (IBDU = 19, 17%). Initial diagnosis of IBDU and UC was modified to CD in 6 patients (6%) after STC. The final diagnosis after the follow-up of 10 ± 6 years switched from CD for 8 patients (9%). The multivariate analysis showed that patients with a colitis evolving for less than 10 years and initial diagnosis of IBDU were the two independent factors associated with an increased risk of diagnosis change to CD (p = 0.03; p = 0.016). At the end of the follow-up, 15 patients (14%) had a definitive stoma.

Conclusions: In patients with IBD, attention must be paid to determine the right restorative strategy to patients with an evolution of the disease less than 10 years or with IBDU who are more at risk to have a diagnosis change to CD after STC.

Keywords: Colitis; Crohn’s colitis; Subtotal colectomy; Ulcerative colitis.

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References

    1. Kalla R, Ventham NT, Satsangi J, Arnott ID (2014) Crohn’s disease. BMJ 349:g6670 - DOI
    1. Ford AC, Moayyedi P, Hanauer SB (2013) Ulcerative colitis. BMJ 346:f432 - DOI
    1. Price AB (1978) Overlap in the spectrum of non-specific inflammatory bowel disease--‘colitis indeterminate’. J Clin Pathol 31:567–577 - DOI
    1. Lee KS, Medline A, Shockey S (1979) Indeterminate colitis in the spectrum of inflammatory bowel disease. Arch Pathol Lab Med 103:173–176 - PubMed
    1. Wells AD, McMillan I, Price AB, Ritchie JK, Nicholls RJ (1991) Natural history of indeterminate colitis. Br J Surg 78:179–181 - DOI

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