Abdominal Emergencies in Inflammatory Bowel Disease

Surg Clin North Am. 2019 Dec;99(6):1141-1150. doi: 10.1016/j.suc.2019.08.007. Epub 2019 Sep 23.

Abstract

Although improved medical therapies have been associated with decreased rates of emergent intestinal resection for inflammatory bowel disease, prompt diagnosis and management remain of utmost importance to ensure appropriate patient care with reduced morbidity and mortality. Emergent indications for surgery include toxic colitis, acute obstruction, perforation, acute abscess, or massive hemorrhage. Given this broad spectrum of emergent presentations, a multidisciplinary team including surgeons, gastroenterologists, radiologists, nutritional support services, and enterostomal therapists are required for optimal patient care and decision making. Management of each emergency should be individualized based on patient age, disease type and duration, and patient goals of care.

Keywords: Abscess; Bowel obstruction; Crohn’s disease; Hemorrhage; Perforation; Stricture; Toxic colitis; Ulcerative colitis.

Publication types

  • Review

MeSH terms

  • Abdomen, Acute / etiology
  • Abdomen, Acute / surgery
  • Anastomosis, Surgical
  • Colectomy / methods*
  • Colitis, Ulcerative / complications
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / therapy
  • Crohn Disease / complications
  • Crohn Disease / diagnosis
  • Crohn Disease / therapy
  • Emergencies
  • Female
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / surgery*
  • Humans
  • Inflammatory Bowel Diseases / complications*
  • Inflammatory Bowel Diseases / diagnosis
  • Intestinal Obstruction / etiology
  • Intestinal Obstruction / physiopathology
  • Intestinal Obstruction / surgery*
  • Intestinal Perforation / etiology*
  • Intestinal Perforation / physiopathology
  • Intestinal Perforation / surgery*
  • Male
  • Patient Care Team / organization & administration
  • Prognosis
  • Risk Assessment
  • Treatment Outcome