engleski

Surgery emergency as primary manifestation of inflammatory bowel disease.

Treatment in (inflammatory bowel disease) IBD is dominantly relied on pharmaceuticals and surgery is reserved for treatment of complications or improving the quality of life for critically ill patients. According to literature, the surgical IBD is not so common initial presentation. One hundred forty seven (147) patients with IBD presented in emergency admission of University Hospital Dubrava (UH Dubrava) in a 5-years period. Eleven patients (11) were initially presented at surgical emergency. Two thirds (72.73%) of surgery emergency group had Crohn’s disease (CD). Six (6) patients had severe CD and 2 intermediate disease activity according to CDAI. A single female patient age 76 presented suspected with acute appendicitis and diagnose of CD was established upon appendectomy. Regarding three patients with UC, one female patient (age 65), with pancolitis and toxic megacolon with CRP 300 was operated because of bowel perforation. She had short history of unspecific abdominal pain and weight loss. The patients suspected on IBD presenting as acute emergencies should receive appropriate diagnose by radiology imaging, estimation of inflammatory markers and emergency endoscoping evaluations, all in order to avoid potentially unnecessary surgery. Further studies of IBD are needed for better understanding biological course of disease in regard to population characteristics, heritage base and potential environmental predispositions for emergency situations as primary manifestation of IBD. In case of suspicion on IBD abundant issues must be resolved prior to surgery with the intention of harmonizing both diagnostic and management side of medical interventions, sustaining quality of treatment and quality of life for patients.

inflammatory bowel disease; emergency surgery; treatment

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