Universidad de GuadalajaraCentro Universitario de Ciencias de la Salud     INFLAMMATORY BOWEL DISEASE:            • Ulcera...
Ulcerative Colitis      (UC)
Ulcerative ColitisDifusse inflammatory disease, contiguous,        initially confined to mucous.
Ulcerative ColitisILEUM         10% - 20%       Reflux Ileitis         20%         30% - 40%         40% - 50%RECTUM
EpidemiologyAges   15-30       60-80          1:1                Preventive
EtiologyUnknownExogen factors: Salmonella, Shigella,  Campylobacter, Clostridium Difficile.Lack of immunitary regulationGe...
Signs and SymptomsDiarreaRectorrhageTenesmusMucus secretionCrampy abdominal painFever
DiagnosisEndoscopy or proctoscopyBarium enema          “Lead tube”Barium contrast radiography.Contrast CT
www.gastrointestinalatlas.com
Disease Presentation                           Low                  Moderate                   SevereDepositions          ...
Medical TreatmentLactose free dietSulfasalazineMesalamineOlzalazineBalsalazideCorticosteroids
Surgical TreatmentURGENT SURGERY                  Fulminant colitis                                Toxic Megacolon   Total...
Crohn’s Disease     (CD)
Crohn’s DiseaseAffects any part of digestive tube.Segmentary distribution Colon and Small Intestine     40% Small Intestin...
EpidemiologyAges   15-30       60-80                       1: 1.5                     Increase                   probabili...
EtiologyUnknownExogen factors: Bacteroides, Clostridium,  Escherichia.Lack of immunitary regulationGenetics: CARD 15, MHC,...
Ileocolic and Small Intestine CDDiarreaRight upper and lower quadrant painPalpable massFever and leukocytosis             ...
Crohn s JejunoileitisSteatorrheaDiarreaNutritional deficiencies        Albumin        Mg        Ca                        ...
Crohn’s ColitisFeverGeneral malaiseDiarreaCrampy abdominal painHematocheziaComplications: Stenosis, Fistulas, Intestinal O...
Anal and Perianal CDAffects 35% of CD patientsIncontinenceBig hemorrhoidsAnal stenosisAnorrectal fistulasPerirrectal absce...
CD DiagnosisEndoscopyBarium contrast radiography   “Rope Sign”CT EnterologyMRI
www.gastrointestinalatlas.com
Medical TreatmentGlucocorticoids5- aminosalicilates (Sulfasalazine,Mesalamine)Immunosuppressive (Azatioprine,Mercaptopurin...
Surgical Treatment- Segmentary colectomy with primaryanastomosis.- Total colectomy with ileorrectal anastomosis- Proctocol...
Right Hemicolectomy - CD• http://www.youtube.com/watch?v=Nkbhc7Ky  S68
Ulcerative Colitis and Crohn’s Disease                          Ulcerative Colitis          Crohn’s Disease Diarrea       ...
Undetermined Colitis15% of IBDUC and CD characteristics and complications Total abdominal colectomy with terminalileostomy
Thanks!
Bibliography• Doherty M. Gerard (2011). Diagnóstico y Tratamiento  Quirúrgicos. México D.F.: Lange.• Fauci A. S. et al. (2...
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Ulcerative Colitis - Crohn's Disease

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Ulcerative Colitis - Crohn's Disease

  1. 1. Universidad de GuadalajaraCentro Universitario de Ciencias de la Salud INFLAMMATORY BOWEL DISEASE: • Ulcerative Colitis • Crohn s Disease Teachers: Dr. Héctor Manuel Virgen Ayala Dr. Benjamín Robles MariscalExponent:Eguía Ornelas Carlos Eugenio Octubre 2011
  2. 2. Ulcerative Colitis (UC)
  3. 3. Ulcerative ColitisDifusse inflammatory disease, contiguous, initially confined to mucous.
  4. 4. Ulcerative ColitisILEUM 10% - 20% Reflux Ileitis 20% 30% - 40% 40% - 50%RECTUM
  5. 5. EpidemiologyAges 15-30 60-80 1:1 Preventive
  6. 6. EtiologyUnknownExogen factors: Salmonella, Shigella, Campylobacter, Clostridium Difficile.Lack of immunitary regulationGenetics: IL-23RInheritance
  7. 7. Signs and SymptomsDiarreaRectorrhageTenesmusMucus secretionCrampy abdominal painFever
  8. 8. DiagnosisEndoscopy or proctoscopyBarium enema “Lead tube”Barium contrast radiography.Contrast CT
  9. 9. www.gastrointestinalatlas.com
  10. 10. Disease Presentation Low Moderate SevereDepositions <4/day 4-6 day >6 dayBlood in stool Few Moderate IntenseFever No Mean <37.5°C Mean > 37.5°Tachycardia No <90 >90ESR <30 mm >30 mmEndoscopic aspect Erythema, decrease Intense erythema, Spontaneus of vascular model, thick granularity, hemorrhage, fine granularity. absence of vascular ulcerations. marks, contact hemorrhage, no ulcerations. Fauci A. S. et al. (2009). Harrison. Principios de Medicina Interna. México, D.F. Mc Graw Hill. Pag. 1889
  11. 11. Medical TreatmentLactose free dietSulfasalazineMesalamineOlzalazineBalsalazideCorticosteroids
  12. 12. Surgical TreatmentURGENT SURGERY Fulminant colitis Toxic Megacolon Total colectomy with terminal ileostomySELECTIVE SURGERY: Abdominal colectomy with ileorrectal anastomosis Total Proctocolectomy with terminal ileostomy Restorative proctocolectomy with anal anastomosis and ileal bag
  13. 13. Crohn’s Disease (CD)
  14. 14. Crohn’s DiseaseAffects any part of digestive tube.Segmentary distribution Colon and Small Intestine 40% Small Intestine 30% Colon 25% Anorrectal 8% Ileocolic and Small Intestine CD Anal and Perianal CD Acute Inflammatory Crohn s Jejunoileitis Chronic Fibrous Crohn’s Colitis
  15. 15. EpidemiologyAges 15-30 60-80 1: 1.5 Increase probabilities
  16. 16. EtiologyUnknownExogen factors: Bacteroides, Clostridium, Escherichia.Lack of immunitary regulationGenetics: CARD 15, MHC, OCTN, DLG5, ATG16L1
  17. 17. Ileocolic and Small Intestine CDDiarreaRight upper and lower quadrant painPalpable massFever and leukocytosis Internal abscessesComplications Fistulas Obstruction
  18. 18. Crohn s JejunoileitisSteatorrheaDiarreaNutritional deficiencies Albumin Mg Ca Vertebral Fractures Vitamin D Vitamin B12
  19. 19. Crohn’s ColitisFeverGeneral malaiseDiarreaCrampy abdominal painHematocheziaComplications: Stenosis, Fistulas, Intestinal Obstruction, Fulminant Colitis and Toxic Megacolon
  20. 20. Anal and Perianal CDAffects 35% of CD patientsIncontinenceBig hemorrhoidsAnal stenosisAnorrectal fistulasPerirrectal abscesses
  21. 21. CD DiagnosisEndoscopyBarium contrast radiography “Rope Sign”CT EnterologyMRI
  22. 22. www.gastrointestinalatlas.com
  23. 23. Medical TreatmentGlucocorticoids5- aminosalicilates (Sulfasalazine,Mesalamine)Immunosuppressive (Azatioprine,Mercaptopurine)AntibioticsInfliximab
  24. 24. Surgical Treatment- Segmentary colectomy with primaryanastomosis.- Total colectomy with ileorrectal anastomosis- Proctocolectomy with ileostomy
  25. 25. Right Hemicolectomy - CD• http://www.youtube.com/watch?v=Nkbhc7Ky S68
  26. 26. Ulcerative Colitis and Crohn’s Disease Ulcerative Colitis Crohn’s Disease Diarrea Marked Present, less severe Blood in stool Caracteristic Infrequent Perianal injuries Infrequent, mild Frequent, complex Toxic dilatation Yes (3-10%) Yes (2-5%) Pain Occasional Frequent Abdominal mass Rare Yes General Symptoms Occasional Frequent Fistulas No Yes Intestinal Obstruction Rare Frequent Fauci A. S. et al. (2009). Harrison. Principios de Medicina Interna. México, D.F. Mc Graw Hill. Pag. 1890
  27. 27. Undetermined Colitis15% of IBDUC and CD characteristics and complications Total abdominal colectomy with terminalileostomy
  28. 28. Thanks!
  29. 29. Bibliography• Doherty M. Gerard (2011). Diagnóstico y Tratamiento Quirúrgicos. México D.F.: Lange.• Fauci A. S. et al. (2009). Harrison. Principios de Medicina Interna. México, D.F.: Mc Graw Hill.• Brunicardi. F. Charles. et al. (2006). Schwartz. Principios de Cirugía. México, D.F.: Mc Graw Hill.• http://www.youtube.com/watch?v=Nkbhc7KyS68
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