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LECTURE  8 Inflammatory Bowel Disease (IBD): Ulcerative Colitis (UC) & Crohn Disease (CD) National O. Bogomolets  Medical University  Faculty Surgery Department N1 Kyiv 2008 Prof. Kucher M.
Inflammatory bowel disease (IBD) is a group of inflammatory conditions of the large intestine and, in some cases, the small intestine. The main forms of IBD are ulcerative colitis (UC)  and Crohn's disease (CD). UC CD
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Epidemiology ,[object Object],[object Object],[object Object],[object Object],[object Object]
UC is a mucosal inflammation:  crypt abscesses  erosion ulcer
A key feature of UC is:   -- continuous involvement of rectum &colon    -- does not involve ileum Inflammatory pseudopolyps Flat displasia
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object]
Endoscopic grades of inflammation activity ,[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Local (colonic) complications
Extraintestinal features
Fulminant UC   ,[object Object],[object Object],[object Object],Before surgery 5  days after surgery 5  mo after surgery   BMI  =19.3
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[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis and workup ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
UC: barium enema, endoscopy, biopsy
Medical treatment: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Indications for Surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Relative Absolute
Operative management Terminal ileostomy J-pouch-rectal anastomosis J- or S-pouch-anal anastomosis
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[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
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CD:  affected areas
Pathology
Pathology
CD clinical manifestations ,[object Object],[object Object],[object Object],[object Object],[object Object]
Lennard-Jones  algorithm for CD differentiation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CD diagnosis
CD diagnosis
W.R.Best  CDAI ,[object Object],[object Object],[object Object],[object Object]
Local complications
Indications for Surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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