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Increased rate of a...
Increased rate of abdominal surgery both before and after diagnosis of celiac disease
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- Kurien, Matthew (author)
- Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield, United Kingdom; Academic Unit of Gastroenterology, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
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- Sanders, David S. (author)
- Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield, United Kingdom; Academic Unit of Gastroenterology, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
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- Ekbom, Anders (author)
- Karolinska Institutet
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- Ciacci, Carolina (author)
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
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- Ludvigsson, Jonas F, 1969- (author)
- Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Paediatrics, Örebro University Hospital, Örebro, Sweden; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom; Department of Medicine, Columbia University College of Physicians and Surgeons, New York NY, USA
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(creator_code:org_t)
- Elsevier, 2017
- 2017
- English.
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In: Digestive and Liver Disease. - : Elsevier. - 1590-8658 .- 1878-3562. ; 49:2, s. 147-151
- Related links:
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http://www.dldjourna...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Background: The detection of celiac disease (CD) is suboptimal.Aims: We hypothesized that misdiagnosis is leading to diagnostic delays, and examine this assertion by determining if patients have increased risk of abdominal surgery before CD diagnosis.Methods: Through biopsy reports from Sweden's 28 pathology departments we identified all individuals with CD (Marsh stage 3; n=29,096). Using hospital-based data on inpatient and outpatient surgery recorded in the Swedish Patient Register, we compared abdominal surgery (appendectomy, laparotomy, biliary tract surgery, and uterine surgery) with that in 144,522 controls matched for age, sex, county and calendar year. Conditional logistic regression estimated odds ratios (ORs).Results: 4064 (14.0%) individuals with CD and 15,760 (10.9%) controls had a record of earlier abdominal surgery (OR=1.36, 95% CI=1.31-1.42). Risk estimates were highest in the first year after surgery (OR=2.00; 95% CI=1.79-2.22). Appendectomy, laparotomy, biliary tract surgery, and uterine surgery were all associated with having a later CD diagnosis. Of note, abdominal surgery was also more common after CD diagnosis (hazard ratio=1.34; 95% CI=1.29-1.39).Conclusions: There is an increased risk of abdominal surgery both before and after CD diagnosis. Surgical complications associated with CD may best explain these outcomes. Medical nihilism and lack of CD awareness may be contributing to outcomes.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- Appendix
- autoimmunity
- celiac
- gall bladder
- inflammation
- surgery
Publication and Content Type
- ref (subject category)
- art (subject category)
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