SHM Converge Scientific Abstract ePoster Gallery-Hyperbaric Oxygen Therapy to Prevent the Need for Diverting Ostomy

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This case report describes a 10-year-old boy with newly diagnosed Crohn’s disease who presented with one month of diarrhea, blood in the stool, fecal incontinence, fever, abdominal pain, and rectal pain. Exam showed a painful ulcerated perianal lesion, and colonoscopy with biopsy confirmed Crohn’s disease. Pelvic MRI demonstrated an intersphincteric fistula extending from the distal anal canal to the left buttock, consistent with severe fistulizing perianal disease.<br /><br />The patient was treated with adalimumab, prednisolone, metronidazole, ciprofloxacin, and sitz baths. While his diarrhea and abdominal pain improved, he continued to have a large perianal ulcer and severe rectal pain, especially with bowel movements. Because a diverting ostomy was being considered, the family and care team opted to try hyperbaric oxygen therapy (HBOT) first in an effort to avoid surgery.<br /><br />He received eleven 90-minute HBOT sessions at 2.4 atmospheres with two short air breaks per session. Despite the limited number of treatments due to insurance constraints, HBOT led to marked improvement in rectal pain and healing of the perianal lesion. No complications were reported, including no barotrauma. He was able to continue medical therapy afterward and gradually wean off steroids while maintaining symptom control.<br /><br />The report highlights HBOT as a promising adjunctive therapy for severe fistulizing Crohn’s disease in children, with potential to promote wound healing and reduce the need for diverting ostomy surgery. The authors note that more pediatric studies are needed to define its effectiveness, ideal treatment duration, and which patients are most likely to benefit.

Asset Subtitle

Barbara Pontes Aires

Meta Tag

Author List Barbara Pontes Aires, Daniel Rauch

Category Clinical Vignettes

Concept Crohn Disease

Concept Fistula

Concept Hyperbaric Oxygen Therapy

Concept Perianal Disease

Concept Colonoscopy

Distinguished Non-Finalist

Presenter Organization Tufts Medical Center

Presenting Author Barbara Pontes Aires

Track Pediatric

Keywords

Crohn’s disease

pediatric

perianal fistula

fistulizing disease

hyperbaric oxygen therapy

adalimumab

rectal pain

ulcerated perianal lesion

diverting ostomy

wound healing

Crohn Disease

Fistula

Hyperbaric Oxygen Therapy

Perianal Disease

Colonoscopy