Postoperative Outcome of Crohn's Disease in 30 Children

Overview

Journal Gut

Specialty Gastroenterology

Date 1998 Nov 21

PMID 9824343

Citations 7

Authors

M Besnard

O Jaby

J F Mougenot

L Ferkdadji

A Debrun

C Faure

P Delagausie

M Peuchmaur

Y Aigrain

J Navarro

J P Cezard

Affiliations

Soon will be listed here.

Abstract

Background: Thirty children operated on for Crohn's disease (CD) were reviewed (1975-1994). The aim of the study was to assess their postoperative outcome.

Patients: 19 boys and 11 girls, aged 15.3 (2) years (range 11.3-20) at surgery were studied.

Results: Surgical indications were acute complications of CD and chronic intestinal illness. Six months after surgery, 11 of 12 patients had been weaned off steroids, and 22 of 23 patients were weaned off nutritional support; 17 patients without recurrence had a mean (SD) weight gain of 2.1 (8) kg and a height gain of 3.36 (3) cm. During 3.1 (2.7) years follow up, 12 patients (40%) had a recurrence of the disease after 19.4 (14) months (means (SD)): supra-anastomotic recurrence (six), severe perianal disease (two), and chronic illness (four). Six of 14 patients who were treated with mesalazine (13) or azathioprine (one) had recurrences. The postoperative recurrence rate was 50% at two years.

Conclusion: Surgical treatment modifies the immediate outcome of severe or complicated CD, but does not prevent recurrence, despite localised resection or prophylactic postoperative treatment. Extension of the disease before surgery seems to be a major risk factor for postoperative recurrence in children.

Citing Articles

Dipasquale V, Antonelli E, Cannavo L, Cavatoi G, Romeo C, Trimarchi G Front Pediatr. 2021; 8:608370.

PMID: 33392119 PMC: 7773926. DOI: 10.3389/fped.2020.608370.

Local peritonitis as the first manifestation of Crohn's disease in a child.

Kambouri K, Gardikis S, Agelidou M, Vaos G J Indian Assoc Pediatr Surg. 2014; 19(2):100-2.

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Natural history of pediatric-onset inflammatory bowel disease: a systematic review.

Abraham B, Mehta S, El-Serag H J Clin Gastroenterol. 2012; 46(7):581-9.

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Surgical management of inflammatory bowel disease.

Baath M, Mahmalat M, Kapur P, Smith N, Dalzell A, Casson D Arch Dis Child. 2006; 92(4):312-6.

PMID: 16670116 PMC: 2083695. DOI: 10.1136/adc.2006.096875.

Surgery results in significant improvement in growth in children with Crohn's disease refractory to medical therapy.

Ranger G, Lamparelli M, Aldridge A, Chong S, Mitton S, Albanese A Pediatr Surg Int. 2006; 22(4):347-52.

PMID: 16518590 DOI: 10.1007/s00383-006-1664-1.

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