Surgical strategies in paediatric inflammatory bowel disease

• Published in: World journal of gastroenterology : WJG Vol. 21; no. 20; pp. 6101 - 6116
• Main Authors: Baillie, Colin T, Smith, Jennifer A
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 28.05.2015
• Subjects: Adolescent; Age Factors; Child; Child, Preschool; Colitis, Ulcerative - classification; Colitis, Ulcerative - diagnosis; Colitis, Ulcerative - epidemiology; Colitis, Ulcerative - surgery; Crohn Disease - classification; Crohn Disease - diagnosis; Crohn Disease - epidemiology; Crohn Disease - surgery; Digestive System Surgical Procedures - adverse effects; Digestive System Surgical Procedures - methods; Humans; Incidence; Review; Risk Factors; Transition to Adult Care; Treatment Outcome; Inflammatory bowel disease; Paediatric; Crohn's disease; Surgery; Ulcerative colitis
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v21.i20.6101

Inflammatory bowel disease (IBD) comprises two distinct but related chronic relapsing inflammatory conditions affecting different parts of the gastrointestinal tract. Crohn's disease is characterised by a patchy transmural inflammation affecting both small and large bowel segments with several distinct phenotypic presentations. Ulcerative colitis classically presents as mucosal inflammation of the rectosigmoid (distal colitis), variably extending in a contiguous manner more proximally through the colon but not beyond the caecum (pancolitis). This article highlights aspects of the presentation, diagnosis, and management of IBD that have relevance for paediatric practice with particular emphasis on surgical considerations. Since 25% of IBD cases present in childhood or teenage years, the unique considerations and challenges of paediatric management should be widely appreciated. Conversely, we argue that the organizational separation of the paediatric and adult healthcare worlds has often resulted in late adoption of new approaches particularly in paediatric surgical practice.