Pharmacologic agents used for the treatment of inflammatory bowel disease (IBD) are similar for both ulcerative colitis (UC) and Crohn disease, with two major differences. Rectally instilled topical agents are effective in UC, but usually not in Crohn disease, and…
Anorectal Crohn disease may consist of fissures, ulcers, abscesses, fistulae, strictures, edematous skin tags, and benign skin tags ( Fig. 96.1 ). The overall prevalence is 36%, but it is 46% when the colon is involved and only 25% when…
Crohn disease is a transmural inflammation of the gastrointestinal (GI) tract characterized by granulomas. It involves primarily the colon and the ileum (regional enteritis) but may involve any part of the GI tract ( Fig. 95.1 ). Approximately 40% of…
A classification of inflammatory bowel disease (IBD) based on scientific data has not gained acceptance. An early attempt was made to classify IBD according to two categories: (1) ulcerative colitis (UC) and Crohn disease; and (2) collagenous colitis, eosinophilic enteritis,…
The surgical treatment of choice for patients requiring colectomy for ulcerative colitis or familial adenomatous polyposis (FAP) is restorative proctocolectomy with ileal pouch anal anastomosis (IPAA). The “pouch” is an ileal reservoir that acts as a neorectum to store fecal…
Colostomies are performed for numerous reasons, including obstructive lesions caused by cancer, severe diverticulitis, severe intractable constipation, and trauma. Ileostomies are performed for the same reasons, but permanent ileostomy is reserved almost exclusively for patients with ulcerative colitis and diffuse…
Ulcerative colitis (UC) is a disease of unknown etiology characterized by diffuse mucosal inflammation of the large bowel ( Fig. 91.1 ). The disease is variable in extent, severity, and clinical course, and knowledge of many aspects remains incomplete. The…
Diverticular Disease of the Colon Diverticulosis of the colon is an acquired condition that results from herniation of the mucosa through defects in the muscle coats ( Fig. 90.1 ). Defects are usually located where the blood vessels pierce the…
Inflammatory changes of the vermiform appendix are the most frequent cause of laparotomy in western countries, where the incidence of appendicitis is approximately 10 times that in eastern countries. The appendix is part of the cecum, and its abdominal marking…
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