Fistulizing Crohn's Disease Presenting After Surgery on a Perianal Lesian

Published March 2016

Singer AA, Gadepalli SK, Eder SJ, Adler J. Fistulizing Crohn's disease presenting after surgery on a perianal lesion.  Pediatrics 2016; 137(3)

Perianal skin lesions, such as skin tags, can be an early presenting sign of Crohn’s disease.  Surgical intervention on these lesions may increase the risk of fistula development and lead to worse outcomes.  This case series examined 8 patients who underwent surgical intervention on what appeared to be benign perianal skin lesions, only to reveal fistulas leading to the diagnosis of Crohn’s disease.

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Improving Clinical Remission Rates in Pediatric Inflammatory Bowel Disease with Previsit Planning

Published July 1, 2016

Savarino JR, Kaplan JL, Winter HS, et al. Improving clinical remission rates in pediatric inflammatory bowel disease with previsit planning.  BMJ Quality Improvement Reports 2016; 5(1): 1-5

Inflammatory Bowel Disease (IBD) is a chronic autoimmune inflammatory disease of the intestine which can lead to malnutrition, poor quality of life, and colon cancer.  Although there is no cure for the disease, clinical remission is the primary goal.  The Center for Inflammatory Bowel Disease at MassGeneral Hospital for Children adopted a Previsit Planning model to identify and discuss symptomatic patients prior to their appointments to identify specific issues that impact disease management.

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Improving pediatric inflammatory bowel disease (IBD) follow-up

Published August 17, 2016

Dykes D, Williams E, Margolis PA, Ruschman J, Bick J, Saeed S, Opipari L. Improving pediatric inflammatory bowel disease (IBD) follow-up.  BMJ Quality Improvement Reports 2016; 5(1)

Standardization of Inflammatory Bowel Disease (IBD) care through participation in the ImproveCareNow (ICN) Network has improved outcomes for pediatric patients with IBD, but under the current care model, our improvements have plateaued. Current ICN model care guidelines recommend health supervision visits every six months. We identified a gap in our practice's ability to ensure either a routine six month follow-up or a rapid follow-up after a disease flare, and a significant number of patients with active disease status during a six month period lacked timely reassessment after interventions or medication changes. Telemedicine provides an alternative method of care delivery to address these gaps, but has had limited use in patients with IBD.

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