Introduction Solitary ulcer of the cecum was first described by Cruveilhier in 1832. The subject of cecal ulcers is confusing and complicated because they are uncommon and have multiple causes. A variety of terms, including solitary cecal ulcer, acute cecal…
Introduction Perianal disease is the presenting symptom in 5% of patients with Crohn disease, but overall up to 80% of patients experience anal symptoms. An understanding of the pathophysiology of the anal disease is basic to appropriate management and successful…
Crohn disease can affect any segment of the intestinal tract, and the colon will be involved in approximately half of afflicted patients. Crohn disease of the colon can entail disease of the large bowel alone or of the large bowel…
Introduction Crohn disease (CD) is a chronic, relapsing, idiopathic inflammatory condition that primarily affects the gastrointestinal tract. The severity and location of CD are variable. CD, a transmural inflammation of the bowel characterized by skip lesions that may involve any…
Introduction Excision of the rectum via a combined abdominal and perineal approach (i.e., an abdominoperineal resection [APR]) has been a time-honored technique for the management of rectal cancer and inflammatory bowel disease (IBD). However, achieving prompt and satisfactory healing of…
Introduction The continent ileostomy has an interesting history. It began as a revolutionary concept and technique, only to fall out of routine use because of technical issues and ultimately a better alternative: the ileal pouch–anal anastomosis (IPAA). Indications for a…
Introduction Despite recent advances in medical therapy, approximately 25% to 30% of patients with ulcerative colitis (UC) will need surgery for refractory colitis or colitis-associated neoplasia. For these patients, a total proctocolectomy with ileal pouch–anal anastomosis (IPAA) is the standard…
Introduction When a total proctocolectomy is required, the ileal pouch–anal anastomosis (IPAA) procedure is favored over an end ileostomy because the IPAA allows continence with defecation by the normal route. The procedure can be performed with favorable results for patients…
Introduction Toxic colitis and megacolon fall within the spectrum of inflammatory bowel disease (IBD). Toxic colitis, also referred to as acute, fulminant, or severe colitis, is a potentially life-threatening form of IBD. Patients display gastrointestinal symptoms in conjunction with signs…
Introduction Despite major advances in the medical treatment of ulcerative colitis (UC), surgery is still frequently required. Because the aim of surgery is to cure the disease, elimination of all colorectal mucosa is ideal. This operative strategy may need to…