Crohn's disease used to be reported a rare inflammatory bowel disease in Korea, But Recently the accumulation of sporadic cases suggests a gradual increase in its incidence. Eleven patients with Crohn's disease had been operated on at the
Department of
General Surgery, National Medical Center during the period from May 1975 to April 1995. In this study, we report on the operative cases as well as their long term follow up.
@ES The results were as follows:
@EN 1) The male-to-female ratio was 2.7:1, and the mean age was 38±14 years. The duration of symptoms varied from 1 month to 10 years, the mean duration was 33 months. Common symptoms were abdominal pain, diarrhea and weight loss,
extraintestinal
manifestation were rare.
2) The most common indication for surgery was an abdominal mass of abscess (45%). The indication for one case was enterocutaneous fistula. Intraoperative Crohn's disease-related complications were abdominal mass or abscess in 7 cases (64%).
intestinal
obstruction in 3 cases (27%) and fistula in 3 cases (27%).
3) The common sites were small bowel and large bowel (45%), small bowel (36%) and colon (18%). The common macroscopic findings were bowel wall thickening and stenosis (100%), skip lesion (55%) and linear ulcers (55%). Microscopic findings were
transmural inflammation (100%) and noncaseating granulomas (64%).
4) In 10 patients (91%), resection with primary anastomosis was necessary, and in one patient, a temporary stoma was done.
5) Three cases (27%) of the ones operated on underwent reopera-tion because of recurrent cymptoms of Crohn's disease.
The above results suggest that the major indications for operating for Crohn's disease are abdominal mass, abscess and intestinal obstructions.
|