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vol.60 número1Resultados y eventos adversos de la sigmoidectomía por cáncer: laparoscopia versus laparotomíaRevista Chilena de Cirugía: índice de publicación según procedencia de los artículos índice de autoresíndice de assuntospesquisa de artigos
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Revista chilena de cirugía

versão On-line ISSN 0718-4026

Resumo

ZUNIGA D, ÁLVARO et al. Analysis of the outcome of patients with Crohn's colitis after surgery with the diagnosis of ulcerative colitis. Rev Chil Cir [online]. 2008, vol.60, n.1, pp.35-40. ISSN 0718-4026.  http://dx.doi.org/10.4067/S0718-40262008000100008.

Bakground: Proctocolectomy with ileal pouch-anal anastomosis (IPAA) is at present the procedure of choice for elective surgical treatment of ulcerative colitis (UC). Colectomy and ileorectal anastomosis (IRA) can be indicated in selected patients. Some patients submitted to these operations for apparent UC may subsequently evolve as Crohn's disease (CD). Objective: To report the course and prognosis of patients who evolved as CD after surgical treatment for apparent UC. Material and method: All the patients who had a surgical treatment for UC, from 1978 to 2003 were included. We identified the patients in which on follow-up the diagnosis changed to CD. Of these patients surgical variables and follow up were analyzed. Results: 114 patients were operated in this period for UC. In 9 patients (8%) their diagnosis changed to CD, based principally on subsequent clinical course and/or histological study: 3 of 20 (15%) after a total colectomy and IRA and in 6 of 84 (7%) after a proctocolectomy with IPAA. The anal canal and perineum were the most frequent localization of CD. Treatment included surgical procedures and medical treatment with anti-inflammatory and/or inmunomodulators. Two patients with a colectomy with IRA needed a proctectomy and ileostomy. Removal of ileal pouch was necessary on 1 of 6 with IPAA. In conclusion a minority of patients operated with the diagnosis of UC evolved as CD. Combined medical and surgical treatment contributed to a low rate of ileal pouch lost

Palavras-chave : Ulcerative colitis; Crohn disease; ileal pouch.

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