Surgical Management of IBD

Question 1

distinguishing histological findings in Crohn’s

Answer 1

• granuloma formation

- transmural inflammation

Question 2

distinguishing histological findings in UC

Answer 2

• mucosal inflammation
• crypt abscess
• goblet cell depletion

Question 3

study of choice for UC

Answer 3

• colonoscopy

Question 4

indications for surgery in UC

Answer 4

• intractable disease
• no response to steroids or “rescue” CSA
• hemorrhage
• perforation
• toxic colitis (toxic megacolon)
• dysplasia

Question 5

elective operation in UC

Answer 5

• total proctocolectomy ileostomy: remove rectum, colon and ileum comes out to the skin

Question 6

emergent operation in UC

Answer 6

• abdominal colectomy with end ileostomy

Question 7

diagnostic studies for crohns

Answer 7

• upper GI
• small bowel follow through
• barium enema
• if you think there is a bowel perforation, DO NOT give barium, give ionic contrast

Question 8

surgery in crohns

Answer 8

• removal of affected portion of bowel will control other symptoms