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PubMed1976

[Arthritis related to intestinal anastomoses].

Jejuno-colic and jejuno-ileal anastomoses may provoke arthritis. The recently recognized physiopathology is that of arthritis due to immune complexes related to pullulation of Escherichia coli and of Bacilus fragilis. These cases of arthritis, usually sensitive to therapy, have, in some stutborn cases, required the re-establishment of intestinal continuity, which in each case has made the joint phenomena disappear.

Antigen-Antibody Complex↗
PubMed1983

The natural history of radiation-induced proctosigmoiditis: an analysis of 88 patients.

The records of 88 patients with radiation-induced proctosigmoidosis seen over an eight year period were reviewed. Eighty-four (95 per cent) had been irradiated for a gynaecological malignancy. The peak incidence of bleeding occurred after a latent period of nine months from the time of irradiation. Twenty-five subjects (28 per cent) had associated injury to the urinary tract. A wide spectrum of radiological abnormalities found on barium enema is described. Twenty-four patients (27 per cent) underwent operations for radiation-induced injury to the colon and urinary tract. Operations on the bowel were attended by a high complication rate (79%). A clinical classification based on bowel symptoms is presented. Those whose only symptom was low grade rectal bleeding (Group I) had the most favourable outcome and of these, 35 per cent stopped bleeding spontaneously by six months. Patients who required frequent transfusions (Group II) had an increasing mortality rate with the passage of time. Patients whose predominant symptoms were pain and bowel dysfunction (Group III) had the highest death rate but some did well after an operative procedure.

Adult↗
PubMed1984

Perianal disease in children and adolescents with Crohn's disease.

The clinical and pathological features of perianal disease in children and adolescents with Crohn's disease have been delineated. Of the 149 patients (mean age 12.1 yr, range 0.75-21 yr, 68% male), 73 (49%) had perianal disease including 51 with fissures and tags, 10 with fistulas, and 12 with abscesses. Ileocolitis was seen in 68% of all patients and in 75% of patients with perianal disease (p greater than 0.10). Rectal inflammation was present in 94% of patients with fistulas or abscesses, or both, versus 63% of all patients without perianal disease (p less than 0.025). Anorectal granulomata were found in 47% of fistula/abscess patients versus 9% of non-perianal disease patients (p less than 0.05). A variety of medical regimens failed to consistently affect these lesions favorably. Four of 10 patients with fistulas healed after 1-5 yr of intermittent discharge. Nine of 12 patients with abscesses required surgical drainage, and 50% subsequently developed chronic fistulas. Granulomata were equally distributed between those patients who healed and those who developed chronic fistulas. Although an important cause of morbidity in childhood Crohn's disease, perianal disease is not progressively destructive in the majority of patients.

Abscess↗