Fistulas and Strictures in - UCI Health...Fistulas and Strictures in Crohn’s Disease Department of...

Fistulas and Strictures in

Crohn’s Disease

Department of Surgery

University of California, Irvine

Steven Mills, MD

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• Inflammatory disease of the colon and rectum

–Limited to colon/rectum

–Inflammation of innermost layer of colon/retum (mucosa)

Ulcerative Colitis

geriatricsyllabus.com

• Inflammatory disease of the intestines

–Anywhere in the GI tract (mouth to anus)

–Inflammation of all layers of the bowel wall

Crohn’s Disease

Layers of Intestinal Wall

• Most common complications (from a surgeon’s perspective)

–Obstruction (stricture)

–Fistula

Crohn’s Disease

Strictures

Crohn’s Disease

Normal Intestinal Wall

Mild Acute Inflammation

Moderate Acute Inflammation

Severe Acute Inflammation

With Steroid Treatment

With Maintenance Treatment

Chronic Inflammation – Scarring

Like a Pipe

• Surgical options are generally resection versus stricturoplasty

Crohn’s Disease

Resection

• Opens up the strictured area without decreasing length of intestine remaining for absorption

Strictureplasty

Stricturoplasty

Endoscopic Therapy

Fistulas

• Fistula is “epithelialized connection between two epithelialized structures” – Small intestine to small

intestine

– Small intestine to skin

– Small intestine to colon

– Small intestine to bladder

– Colon to bladder

– Colon to skin

• Often treated with resection

Crohn’s Fistula

Fistula

Inflammation is Like Welding

Fistula

Perianal Fistulas

• Inflammation can lead to strictures or fistulas

• Medications to control inflammation may prevent both problems

• Surgery often used to fix stictures and fistulas

Crohn’s Strictures and Fistulas

Fistulas and Strictures in - UCI Health...Fistulas and Strictures in Crohn’s Disease Department of...

Documents

fistulas biliares

Diseases of the Colon - acoi.org€¦ · Ulcerative Colitis Crohn’s Disease Anatomy Endoscopy Gross Pathology Biopsy ... Appendicitis-like presentation Fistulas Abscesses Gallstones

Endoscopic management of esophageal strictures review GIE.pdf · Caustic strictures Caustic (aka corrosive) strictures, most commonly because of ingestion of concentrated alkali solutions

Validity and safety of endoscopic biliary stenting for ...€¦ · biliary strictures and strictures in other parts of the biliary sys-tem. On cholangiography of biliary strictures

Rectovaginal fistulas

Speaker: Douglas G. Adler, MD, FACG...STRICTURES, FISTULAS, AND LEAKS Douglas G. Adler, MD, FACG University of Utah School of Medicine Huntsman Cancer Institute Salt Lake City, Utah

Fistulas arterio venosas

Fistulas anales

Choledochoduodenal fistulas

Female to Male Genital Reconstruction - SMSNA - · PDF fileFemale to Male Genital Reconstruction Curtis Crane MD. Introduction ... Urethral Strictures and Fistulas after Phalloplasty

Arteriovenous Fistulas

Dialysis Fistulas

Abscesos fistulas perianales

biliary strictures

Obstetrical Fistulas

Fistulas urogenitales

Enterocutaneous fistulas ppt

Fistulas Vaginales

Genitourinary Fistulas

Enterocutaneous fistulas