The authors present the result of brief survey of the 10 cases of Crohn´s disease those have been
treated at the Chonnam medical school hospital during past 8 yrs from 1968 to 1970 with review of
the pertinent articles. Both sexes were equally involved, 5 males and 5 females among 10 cases.
Average age of onset was 29 and, in 9 cases, occured before 40 yrs of age.
The pathologic lesions were located in the ileum (mainly terminal ileum) in 5 cases, ileocecal
region in 2 cases, jejunum in 1 case, ascending colon in 1 case, and duodenum in 1 case. The present
study of duodenal involvement in 1 case is very significant because of the first experience in Korea.
The preoperative average duration of symptoms was ab. 2 months and usual subjective symptoms
were abdominal pain on R.L.Q., mild fever elevation, anorexia, nausea and vomiting in that order.
One patient had a complication of acute free perforation which was shown as very rare instance in
other reports, and complication of anal fistula or abscess was not observed.
The symptomatic diagnosis is very difficult because of deficiency of definite characteristic symptoms
in Crohn´s disease.
On Roentgen examination, so called "String sign" was noted in 7 cases those lesion were located
in the duodeum, jejunum and terminal ileum. In case of duodenal involvement there were multiple
minimal ulceratios in mucosa, but cobble stone pattern and pseudodiverticula pattern was not observed.
Grossly, the margin of lesion was sharply demarcated from healthy portion.
Microscopically, interstitial edema, obstruction or ectasia of the lymphatic duct, lymphoid hyperp
lasia, endothelial proliferation and perivascular histiocytosis were noted more frequently in submucosa
with subacute or chronic cellular infiltration in whole layers associated with lymphocytic aggregation
extending to muscular layer. Langerhan´s giant cells and lymphocytes aggregation were observed in
mesenteric lymphnode, but caseous necrosis was not observed.
The problems in the management of Crohn´s disease are not completely solved, but it is usual to
be managed by conservative medical treatment unless serious complications or frequent recurrence is
noticed. Bypass was applied in 3 cases of the duodenal and ileocecal involvement, and resection was
carried out in 7 cases of ileum, jejunum, and ascending colon with primary resection in 6 cases and
2ndary resection in 1 case. There have been no postoperative death and recurrence in follow up study
to date.
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