Surgical strategies in paediatric inflammatory bowel disease

作     者：Colin T Baillie Jennifer A Smith 

作者机构：Department of Paediatric SurgeryRoyal Liverpool Childrens Hospital 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2015年第21卷第20期

页      面：6101-6116页

核心收录：

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

主　　题：Inflammatory bowel disease Ulcerativecolitis Crohn's disease Paediatric Surgery 

摘      要：Inflammatory bowel disease(IBD) comprises two distinct but related chronic relapsing inflammatory conditions affecting different parts of the gastrointestinal tract. Crohn s disease is characterised by a patchy transmural inflammation affecting both small and large bowel segments with several distinct phenotypic presentations. Ulcerative colitis classically presents as mucosal inflammation of the rectosigmoid(distal colitis), variably extending in a contiguous manner more proximally through the colon but not beyond the caecum(pancolitis). This article highlights aspects of the presentation, diagnosis, and management of IBD that have relevance for paediatric practice with particular emphasis on surgical considerations. Since 25% of IBD cases present in childhood or teenage years, the unique considerations and challenges of paediatric management should be widely appreciated. Conversely, we argue that the organizational separation of the paediatric and adult healthcare worlds has often resulted in late adoption of new approaches particularly in paediatric surgical practice.