Publication details

Naše zkušenosti s léčbou masivního krvácení u Crohnovy nemoci pomocí anti-TNF terapie

Title in English Experience in the treatment of severe bleeding in Crohn's disease with anti-TNF therapy
Authors

ULBRYCH Jan ŠLAPALOVÁ Klára ONDREJKOVÁ Alena DRÁBKOVÁ Jana VANÍČEK Jiří KIANIČKA Bohuslav

Year of publication 2018
Type Article in Periodical
Magazine / Source Gastroenterologie a hepatologie
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.14735/amgh2018251
Keywords Crohn Disease; Hemorrhage gastrointestinal bleeding
Attached files
Description Massive gastrointestinal bleeding (enterorrhagia) is a rare complication of Crohn's disease (CD-Crohn's disease) occurring in approximately 4% of patients. The most common cause is deep ulceration in the inflammation of the affected part of the gastrointestinal tract. Risk factors for massive bleeding have not yet been identified. A prerequisite for successful treatment is to determine the source of bleeding and the extent of inflammatory disorder. On the basis of the results of the investigation methods, we can make a decision on the optimal treatment process. In this work we describe the cases of two patients with CD hospitalized at our workplace in the years 2016-2017. In the first case, this is a patient whose relapses in the colon have required hospitalization. During the hospitalization, however, conventional therapy did not lead to remission, and despite this treatment significant enterorrhagia appeared. In the second case, massive enterorrhagia appeared as the primary manifestation of CD relapse in the terminal ileum and colon. Conventional therapies did not lead to bleeding and the induction of remission. On the contrary, despite this treatment enteroragia significantly progressed. In these selected case studies, we want to demonstrate the efficacy of anti-TNF therapy in blocking gastrointestinal bleeding in CD patients. We want to point out the benefit of the rapid onset of this treatment in the absence of conventional therapy or the inability (risk) of other therapeutic methods (miniinvasive access, surgical treatment) for extensive inflammatory digestive tract disorder.