Digestive perianastomotic ulcerations and Crohn's disease.

Authors :: Frémond ML
Viala J
Tréton X
Roy M
Berrebi D
Gottrand F
Bonnard A
Martinez-Vinson C
Hugot JP
Source :: Journal of Crohn's & colitis [J Crohns Colitis] 2014 Dec; Vol. 8 (12), pp. 1624-31. Date of Electronic Publication: 2014 Aug 06.
Publication Year :: 2014
Abstract: Background and Aims: Digestive perianastomotic ulcerations (DPAU) have been occasionally reported as late complications of neonatal or childhood surgery.<br />Methods: We report here a series of 14 new cases.<br />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).<br />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.<br /> (Copyright © 2014 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.)