Gastroenterol Clin North Am. 2023 Sep;52(3):579-587.doi: 10.1016/j.gtc.2023.06.001.

Aaron M Lipskar ¹

Author information

¹Surgery and Pediatrics, Division of Pediatric Surgery, Cohen Children's Medical Center, Zucker School of Medicine at Hofstra/Northwell, 1111 Marcus Avenue, Suite M15, New Hyde Park, NY 11042, USA. Electronic address: alipskar@northwell.edu.

Abstract

Surgery for children and adolescents with IBD is often thought of as a combination of a failure of medical management and the only option for the severe complications of the disease such as uncontrolled GI bleeding, perforation, fistulae, sepsis, and bowel obstruction. However, in CD, surgery can sometimes be an appropriate option to control disease progression, improve symptoms, allow children to get back on the growth curve, and avoid the toxicities of prolonged use of steroids. In UC, the decision to operate is theoretically curative but the long-term options mandate either intestinal continuity with an ileal pouch or a lifelong ileostomy, both of which can have significant impacts in patients' quality of life.