Crohn disease (original) (raw)

Natural history of Crohnʼs disease

Inflammatory Bowel Diseases, 2010

Background: Childhood-onset Crohn's disease (CD) might reflect a more severe form of disease. To test this hypothesis we analyzed the long-term natural history of CD in an adult cohort of patients with childhood-onset compared to adult-onset CD. Methods: We selected 206 childhood-onset CD patients among 2992 adult patients with a diagnosis of CD established before December 31, 2000. Disease characteristics were prospectively assessed during follow-up until December 2007 and compared to adult-onset CD patients matched 2 to 1 on gender, year of CD diagnosis, and disease location. Results: Compared to adult-onset CD, patients with childhoodonset CD were more likely to have a severe disease, with an increased year-by-year disease activity index (37% of patient-years in childhood-onset group versus 31% in the adult-onset group, P < 0.001). Immunosuppressant requirement was also increased with a 10-year cumulative risk of 54 6 3% in childhood-onset CD group versus 45 6 2%, in the adult-onset CD group (P < 0.001). Cumulative risks of stricturing and penetrating complications and surgical resections were not statistically different between groups. Accordingly, these events occurred at a younger age in the childhood-onset CD group. At the age of 30 years the actuarial risk of having undergone an extensive intestinal resection was 48 6 5% in the childhoodonset group versus 14 6 2% in the adult-onset group (P < 0.001). Conclusions: Patients with childhood-onset CD exhibit a more active disease and require more immunosuppressive therapy. This feature is observed irrespective of the disease location, suggesting an intrinsic more severe phenotype.

Natural history of perianal Crohn's diseaseTen year follow-up: A plea for conservatism

American Journal of Surgery, 1980

Perianal disease is a frequent manifestation of Crohn's disease . The perianal lesions include skin erosions and ulceration, sentinel skin tags, fissures, ulcers and induration or stricture of the anal canal and perianal fistulas . One hundred fiftythree patients attending a Crohn's follow-up clinic in our hospital were reviewed in 1968. One hundred nine of these patients had perianal fistulas and fissures, and some also had skin tags . We obtained data on the natural history of perianal Crohn's disease by reviewing as many as possible of the patients seen in our hospital 10 years ago.

Crohn's disease of the colon

The American Journal of Medicine, 1974

of weekly clinicopathologic conferences held in the Barnes and Wohl Hospitals, are published in each issue of the Journal. These conferences are participated in jointly by members of the Departments of internal Medicine and Pathology of the Washington University School of Medicine. A 65 year old man (J.C.) was admitted to Barnes Hospital on May 16, 1973, because of diarrhea and weight loss. He died 34 days later.

On the etiology of Crohn disease

Proceedings of the National Academy of Sciences, 1996

Crohn disease (CD) is a chronic, panenteric intestinal inflammatory disease. Its etiology is unknown. Analogous to the tuberculoid and lepromatous forms of leprosy, CD may have two clinical manifestations. One is aggressive and fistulizing (perforating), and the other is contained, indolent, and obstructive (nonperforating) [Gilberts, E.

ATYPICAL MANIFESTATIONS OF CROHN'S DISEASE: REVIEW ARTICLE (Atena Editora)

ATYPICAL MANIFESTATIONS OF CROHN'S DISEASE: REVIEW ARTICLE (Atena Editora), 2023

Crohn's disease is a chronic inflammatory process that still has no known etiology. Clinical manifestations are usually of an inflammatory, obstructive and fistulizing nature. The most frequent sites of involvement are the small and large intestines, however, in 50% of cases they affect the perineal region, stomach, esophagus and mouth. Associated or isolated extraintestinal manifestations are manifested in the skin, joints, eyes, and liver. It is worth remembering that these are directly proportional to the intensity of the intestinal inflammatory process. The diagnosis of the disease is made with a combination of clinical data analysis (anamnesis, physical examination and complementary tests). Regarding the biological symptoms, patients affected by the disease can also trigger emotional disturbances during its outcome, thus, the psychological impact presents a great transformation in the patient's own experience, leading him to suffer serious emotional damage when the chronicity of the disease is discovered. Crohn. The physical limitations produced by this disease associated with clinical symptoms, promote direct impacts on intersocial relationships, especially in the family, bringing with them feelings of fear and insecurity, resulting from the physical changes that in certain cases can be clearly visible.

Place de la chirurgie dans le traitement de la maladie de Crohn

Acta Endoscopica, 2003

Les auteurs ont confrontal leur expdrience dans le traitement chirurgical de la maladie de Crohn de l'adulte avec les rdsultats de quelques grandes s6ries rapportds dans la littdrature. Au cours de 25 ans, 533 opdrations de r6section intestinale ont 6td rdalis6es, incluant une opdration initiale chez 348 patients (177 femmes, 171 hommes, gge mddian : 33 ans, extremes : 18-80 ans), sans aucune mortalitd. Les principales indications de la rdsection intestinale, limitde aux ldsions macroscopiques, ont 6t6 les stdnoses et fistules symptomatiques (respectivement 45,7 % et 37 %). Comme dans les autres sdries rapportdes, la r6cidive ddfinie comme une rdopdration a dtd frdquente avec un taux cumulatif de rdopdration de 11% aprbs 5 arts, de 29 % apr6s 10 ans, de 41% aprbs 15 ans et de 70 % apr~s 20 ans. Cependant, le taux cumulatif de rdopdration h 10 ans a dt6 nul chez les patients ayant subi une coloproctectomie totale avec ildostomie. Chez 18 patients, dont 8 avaient ddjh subi une premi6re opdration, 68 strieturoplasties ont dtd rdalisdes, assocides h une r6section ildo-colique et/ou une rdsection grale segmentaire chez 15. Aprbs stricturoplastie, le taux de rdopdration a dtd de 33 % pendant un suivi mddian de 33,5 mois (8-144).