Doença de Crohn na Criança: Indicações Cirúrgicas

Abstract

Introduction: Crohn's Disease (CD) is an Inflamatory Bowell Disease (IBD), which consists on a chronic recurrent condition. It's incidence is rising worldwide in adult and pediatric population. About 25% of new diagnosis are children and epidemiologic data show an increase of the prevalence in pre puberty, with a prevalence peak in adolescence. The diagnosis in childhood brings a more aggressive and extensive character to the disease, and a faster development of complications related to this condition. The disease is frequently refractory to medical therapy, frequently requiring surgical intervention. Thus, the present article aims to approach the main surgical recommendations in CD, in pediatric age. Methods: The research was carried out on the Pubmed platform. A total amount of 44 articles were collected, including cross-references. Results/discussion: the most affected patients by the disease are adolescents, with a peak incidence at 15 years. In this age group, there is a strong influence of genetic factors such as the IBD1 (NOD2/CARD15) gene. This influence is characterized by a wider presentation and, besides the advances in pharmaceutical industry, there is still a lack of consensus about its influence of these advances in the reduction of surgical intervention. Even though the lack of medical treatment response and the growth restriction caused by this disease are important surgical influences, the main surgical indications remain the direct complications of the disease, mainly the perianal disease. Conclusion: CD is a dynamic and extensive condition in pediatric age. Besides the advances in medical therapeutics, there hasn't been a significant reduction in the incidence of surgical intervention.