Inflammatory Bowel Disease (IBD): Ulcerative Colitis and Crohn’s Disease
Ulcerative colitis is a chronic inflammation of the rectum and colon, which begins between the third and fourth decade of life and presents as watery and bloody diarrhea, associated with abdominal pain, fever and poor general condition.
The amount of colon and rectum affected can vary among individuals with Ulcerative Colitis, as well as the intensity of symptoms. Acute severe ulcerative colitis requires hospital admission and the need for urgent surgery in those cases that do not respond to initial medical treatment or suffer from any complications. In the situation of chronic disease, some patients may require elective surgery (restorative colectomies or panproctocolectomies) if their disease is refractory to treatments and in addition, chronic disease may predispose to the appearance of colon cancer. Minimally invasive surgery is the treatment of choice both in emergency situations and in scheduled surgery.
Crohn’s disease is another chronic inflammatory process of the intestine, in which the intestinal mucosal barrier is compromised allowing the invasion of intestinal bacteria. The initial treatment is medical, but surgery is considered to treat complications and improve the quality of life of patients. These complications refer to the appearance of fistulas, perforation and stenosis with intestinal obstruction. Likewise, these patients will present, during the course of their disease, involvement of the rectum and anus, resulting in complex perianal fistulas that will require surgery.
Crohn’s disease (Techniques):
- Treatment of complex perianal fistulas,
- laparoscopic intestinal resection for the treatment of enteric fistulas or strictures,
- stricturoplasty,
- bowel conservative techniques
Ulcerative Colitis (techniques):
- Subtotal colectomy
- Restorative panproctocolectomy or not
- Anal reservoir
- Kock reservoir