Crohn's Disease & New Diagnosis of Colon Cancer Algorithm

Crohn's Disease & New Diagnosis of Colon Cancer Algorithm
 - Define Colonic Disease Extent, Activity & Review Prior Colonoscopies
 - Chromo Exam: Eval for Flat Dysplasia or Resectable/Non-Resectable Dysplasia in Remaining Colon
 - Complete Appropriate Ca Staging
 - Assess Perianal Disease Activity (MR Pelvis ± EUA)
 - Consult CRS, Medical Oncology/Tumor Board, Gl Psych, Nutrition
Considerations for HC vs. IRA
 • Hemicolectomy:
    - ↑↑ absorptive capacity = improved QOL 
    - ↑↑ area of "at risk" to survey = ↑ risk metachronous lesion
    - Requires long-term surveillance exams
 • Ileorectal Anastomosis:
    - Intact rectum = improved QOL
    - ↑ rates intact fertility and sexual dysfunction vs IPAA
    - Ease of surveillance exams
Risk of Metachronous Dysplasia/Cancer
 • Up to 39% of pts with CRC may develop metachronous CA despite yearly exam
 • Up to 46% of pts with dysplasia may have new dysplasia
 • ≠ recurrence HC vs STC
 • TPC eliminates risk of recurrence

Dr. Waseem Ahmed @Waseem_AhmedMD

#Crohns #Disease #Colon #Cancer #algorithm #management #treatment #ibd
Contributed by

Dr. Gerald Diaz
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: | Twitter:
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