MondayNightIBD | GETECCU X MNIBD Case Convo | March 27, 2023 | Vicent Hernandez, MD, PhD *Pre-assessment* Survey

Before you participate in this activity, please take this pre-assessment. Taking this pre-assessment does not immediately qualify learners to earn credit.

Certificates of credit will only be sent to learners who also receive a passing score on the post-test (separate from this survey), and fill out the evaluation form and application for credit.

2.A 52-year-old woman diagnosed with Crohn’s disease A2L1+4B2-3, former smoker. Jejunal resection at 31 years because of stricturing disease. She was started on adalimumab at 49 years, but she developed a new fistula arising the from terminal ileum to the psoas at 52 years. An ileocecal resection with Kono-S anastomosis was performed.

In addition to starting effective therapy, which one is true regarding post-operative recurrence:(Required.)

Postoperative recurrence should be assessed with monthly fecal calprotectin

Tobacco smoking is a protective factor against post-operative recurrence

Kono-S anastomosis is considered a risk factor for post-operative recurrence

Patients should be monitored with early colonoscopy (i.e. after 6 months) to assess postoperative recurrence

3.A 52-year-old woman diagnosed with Crohn’s disease A2L1+4B2-3, former smoker. Jejunal resection at 31 years because of stricturing disease. She was started on adalimumab at 49 years, but she developed a new fistula arising the from terminal ileum to the psoas at 52 years. An ileocecal resection with Kono-S anastomosis was performed.

With respect to the pharmacological treatment to prevent postoperative recurrence:(Required.)

Metronidazole is effective in the long-term to prevent post-operative recurrence

A meta-analysis has shown that anti-TNF drugs are more effective than thiopurines to prevent post-operative recurrence

The presence of Rutgeerts i1 lesions at colonoscopy warrants treatment intensification

Anti-TNF drugs, as compared to placebo, have shown a reduction in clinical postoperative recurrence, but do not improve endoscopic postoperative recurrence

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