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Obstruction and pseudo-obstruction in inflammatory bowel disease

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Author(s): K.H. Katsanos | V.E. Tsianos | M. Maliouki | M. Adamidi | I. Vagias | E.V. Tsianos

Journal: Annals of Gastroenterology
ISSN 1108-7471

Volume: 23;
Issue: 4;
Start page: 243;
Date: 2010;
Original page

ABSTRACT
Intestinal obstruction and pseudo-obstruction represents a severe complication and a potential emergency in Crohn’s disease and ulcerative colitis. Such intestinal complications are of great importance and may require urgent surgical management. This review discusses the clinical importance, the risk factors and the pathophysiological basis of this phenomenon. Diagnosis and imaging of obstruction together with common and rare causes of obstruction and pseudo-obstruction including toxic megacolon are extensively reviewed. Non-surgical treatment of obstruction in inflammatory bowel disease is reviewed including pharmacologic colonic decompression and infliximab use. Endoscopy in pseudo-obstruction, toxic megacolon, and in stenoses and strictures is reviewed and the setting of the optimal time for surgery in obstructing cases is provided. Strictureplasty or resection in stenoses, post-surgical obstructions as well as available prognostic markers of obstruction and pseudo-obstruction are critically revised.
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