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. 1980 Jan;132(1):1–6.

The Operative Management of Crohn Disease

David A Simonowitz 1
PMCID: PMC1271933  PMID: 7376642

Abstract

The natural history of Crohn disease* is varied and unpredictable, and its cause is not known. No modality of treatment has definitely been shown to alter its course.

Surgical treatment was carried out in a consistent fashion in 141 consecutive patients with Crohn disease. The indications for surgical operation were the complications of the disease only; these included fistula, abscess, obstruction and hemorrhage. Preoperative evaluation included upper gastrointestinal examination, barium enema, intravenous pyelogram, proctoscopy, and nutritional and volume support. In 76 of these patients previous operations had been carried out for Crohn disease.

The surgical treatment was based upon the specific complication present, with adherence to the principle of resection of diseased tissue only. Ureterolysis also was necessary in 20 percent of these patients. The operative mortality was 1.4 percent, postoperative complications occurred in 54 patients and the surgical recurrence rate was 26 percent. A favorable result was accomplished in 85 percent of the patients.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arvanitakis C., Manier J. W. Crohn's disease: a clinical study of 75 patients. Am J Gastroenterol. 1973 Jun;59(6):532–540. [PubMed] [Google Scholar]
  2. Atwell J. D., Duthie H. L., Goligher J. C. The outcome of Crohn's disease. Br J Surg. 1965 Dec;52(12):966–972. doi: 10.1002/bjs.1800521214. [DOI] [PubMed] [Google Scholar]
  3. BARBER K. W., Jr, WAUGH J. M., SAUER W. G. Surgical treatment of complication of regional enteritis. A 10-year follow-up. Arch Surg. 1963 Mar;86:442–444. doi: 10.1001/archsurg.1963.01310090092017. [DOI] [PubMed] [Google Scholar]
  4. Barber K. W., Waugh J. M., Beahrs O. H., Sauer W. G. Indications for and the Results of the Surgical Treatment of Regional Enteritis. Ann Surg. 1962 Sep;156(3):472–480. doi: 10.1097/00000658-196209000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Brill C. B., Klein S. F., Kark A. E. Regional enteritis and entero-colitis: a study of 74 patients over 15 years. Ann Surg. 1969 Nov;170(5):766–774. doi: 10.1097/00000658-196911000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. COLCOCK B. P., FORTIN C. SURGICAL TREATMENT OF REGIONAL ENTERITIS: REVIEW OF 85 CASES. Ann Surg. 1965 May;161:812–818. doi: 10.1097/00000658-196505000-00019. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. COLCOCK B. P., VANSANT J. H. Surgical treatment of regional enteritis. N Engl J Med. 1960 Mar 3;262:435–439. doi: 10.1056/NEJM196003032620903. [DOI] [PubMed] [Google Scholar]
  8. De Dombal F. T., Burton I., Goligher J. C. Recurrence of Crohn's disease after primary excisional surgery. Gut. 1971 Jul;12(7):519–527. doi: 10.1136/gut.12.7.519. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Enker W. E., Block G. E. Occult obstructive uropathy complicating Crohn's disease. Arch Surg. 1970 Aug;101(2):319–326. doi: 10.1001/archsurg.1970.01340260223033. [DOI] [PubMed] [Google Scholar]
  10. Enker W. E., Block G. E. The operative treatment of Crohn's disease complicated by fistulae. A personal consecutive series. Arch Surg. 1969 Apr;98(4):493–499. [PubMed] [Google Scholar]
  11. Farmer R. G., Hawk W. A., Turnbull R. B., Jr Clinical patterns in Crohn's disease: a statistical study of 615 cases. Gastroenterology. 1975 Apr;68(4 Pt 1):627–635. [PubMed] [Google Scholar]
  12. Fielding J. F., Cooke W. T., Williams J. A. The incidence of recurrence in Crohn's disease. Surg Gynecol Obstet. 1972 Mar;134(3):467–469. [PubMed] [Google Scholar]
  13. Fromm H., Wilson F. A., Rodgers J. B., Jr, Balint J. A. Granulomatous bowel (Crohn's disease. A retrospective study of the course and treatment. Arch Intern Med. 1971 Nov;128(5):739–745. doi: 10.1001/archinte.128.5.739. [DOI] [PubMed] [Google Scholar]
  14. Glotzer D. J., Stone P. A., Patterson J. F. Prognosis after surgical treatment of granulomatous colitis. N Engl J Med. 1967 Aug 10;277(6):273–279. doi: 10.1056/NEJM196708102770601. [DOI] [PubMed] [Google Scholar]
  15. Greenstein A. J., Sachar D. B., Pasternack B. S., Janowitz H. D. Reoperation and recurrence in Crohn's colitis and ileocolitis Crude and cumulative rates. N Engl J Med. 1975 Oct 2;293(14):685–690. doi: 10.1056/NEJM197510022931403. [DOI] [PubMed] [Google Scholar]
  16. Homan W. P., Tang C. K., Thorbjarnarson B. Acute massive hemorrhage from intestinal Crohn disease. Report of seven cases and review of the literature. Arch Surg. 1976 Aug;111(8):901–905. doi: 10.1001/archsurg.1976.01360260069019. [DOI] [PubMed] [Google Scholar]
  17. Krause U., Bergman L., Norlén B. J. Crohn's disease. A clinical study based on 186 patients. Scand J Gastroenterol. 1971;6(1):97–108. doi: 10.3109/00365527109180677. [DOI] [PubMed] [Google Scholar]
  18. Lennard-Jones J. E., Stalder G. A. Prognosis after resection of chronic regional ileitis. Gut. 1967 Aug;8(4):332–336. doi: 10.1136/gut.8.4.332. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Lennard-Jones J. E., Stalder G. A. Prognosis after resection of chronic regional ileitis. Gut. 1967 Aug;8(4):332–336. doi: 10.1136/gut.8.4.332. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. SCHOFIELD P. F. THE NATURAL HISTORY AND TREATMENT OF CROHN'S DISEASE. Ann R Coll Surg Engl. 1965 May;36:258–279. [PMC free article] [PubMed] [Google Scholar]

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