Digestive perianastomotic ulcerations and Crohn's disease. (1st December 2014)

• Record Type: Journal Article
• Authors: Frémond, Marie-Louise; Viala, Jérome; Tréton, Xavier; Roy, Maryline; Berrebi, Dominique; Gottrand, Frédéric; Bonnard, Arnaud; Martinez-Vinson, Christine; Hugot, Jean-Pierre
• Is Part Of: Journal of Crohn's and colitis. Volume 8:Number 12(2014)
• Page Start: 1624
• Page End: 1631
• Publication Date: 2014-12-01
• Subjects: Digestive perianastomotic ulcerations -- Crohn's disease -- Ulcers -- Ileocolonic anastomosis -- Small bowel surgery -- Nod2; Inflammatory bowel diseases -- Periodicals; 616.344005
• DOI: 10.1016/j.crohns.2014.06.011
• Languages: English
• ISSNs: 1873-9946

Abstract

Abstract: Background and aims: Digestive perianastomotic ulcerations (DPAU) have been occasionally reported as late complications of neonatal or childhood surgery. Methods: We report here a series of 14 new cases. Results: Cases were revealed by severe anemia, diarrhea, abdominal pain and growth failure in average 11.5 years after surgery. Ulcerations were most often multiple (n = 11), located on the upper part of ileocolonic anastomoses (n = 12) and difficult to treat. No granulomas were seen but lymphoid follicles were frequent. In addition, either ASCA or ANCA were positive in 4/9 tested patients and 8/11 genotyped patients exhibited a NOD2 mutation (P < 0.0002 when compared to French healthy controls). Conclusion: Altogether, these findings argue for common physiopathological features between DPAU and Crohn's disease and for a prospective follow-up of selected operated children to explore the early events involved in gut inflammatory lesions.