Time to talk about #surgery! βοΈ
#AIBD2021 @IBDConference #GITwitter #surgerytwitter
@AshburnMd @pakotze
#AIBD2021 @IBDConference #GITwitter #surgerytwitter
@AshburnMd @pakotze
@NMH_SHanauerMD: Options: TNFs, VDZ, UST. Consider UST (easy, safe).
Ileal stricture, lots of fibrotic disease, abscess, fistulae. Patient is still refusing surgery.
@MLongMD: "There are no medical options."
Unfortunately, this patient should have undergone surgery years ago.
β οΈPro-tip: have pt discuss with other patients who have undergoneβοΈ
@MLongMD: "There are no medical options."
Unfortunately, this patient should have undergone surgery years ago.
β οΈPro-tip: have pt discuss with other patients who have undergoneβοΈ
She agrees to surgery.
@FicheraAlessand: gametime decision about diversion.
Pathology: adenocarcinoma.
@MLongMD: consequence of longstanding untreated chronic intestinal inflammation.
Now CD and cancer. What next?
@NMH_SHanauerMD: if good QoL, maybe nothing.
@FicheraAlessand: gametime decision about diversion.
Pathology: adenocarcinoma.
@MLongMD: consequence of longstanding untreated chronic intestinal inflammation.
Now CD and cancer. What next?
@NMH_SHanauerMD: if good QoL, maybe nothing.
Involve surgery early!
Still significant anoperineal disease.
@FicheraAlessand: You really need to control the sepsis before considering closing the ileostomy.
@AshburnMd: source control!
@NMH_SHanauerMD: biologic therapy did not control the perianal disease but did control her colonic disease.
@FicheraAlessand: You really need to control the sepsis before considering closing the ileostomy.
@AshburnMd: source control!
@NMH_SHanauerMD: biologic therapy did not control the perianal disease but did control her colonic disease.
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