Skip to main content
Gut logoLink to Gut
. 1980 Nov;21(11):933–940. doi: 10.1136/gut.21.11.933

Crohn's disease of the distal ileum.

C S Higgens, R N Allan
PMCID: PMC1419288  PMID: 7450558

Abstract

A clinical and statistical analysis has been undertaken in a consecutive series of 227 patients with Crohn's disease involving the distal ileum under long-term review between 1944 and 1978. We have determined the long-term prognosis, cumulative reoperation rates after each resection, mortality rates, and their causes. Actuarial analysis has shown that the reoperation rates are similar after first, second, and third resections. There was no evidence that additional operations increase the risk of yet more resections. Reoperation rates were very little influenced by the age at diagnosis of the underlying Crohn's disease. A short interval from diagnosis of Crohn's disease to the first resection tended to increase the reoperation rate in the short term but there was no overall long-term effect. There was a two-fold increase in mortality risk when compared with the general population. Half the deaths were unrelated to the underlying Crohn's disease and, in this group, the incidence and causes were similar to those expected in the general population matched for age, sex, and years at risk. Of the disease related deaths many occurred in the early years of experience. Only four patients in the series have died of Crohn's disease in the last 10 years. One hundred and ninety-three patients are still alive after a mean interval of 16.1 years from the diagnosis of Crohn's disease. Full information is available on 185, of whom 161 are well and symptom free. Seven have minor problems, while 17 are unwell (nine with radiological evidence of recurrent disease).

Full text

PDF
933

Selected References

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

  1. BERKSON J., GAGE R. P. Calculation of survival rates for cancer. Proc Staff Meet Mayo Clin. 1950 May 24;25(11):270–286. [PubMed] [Google Scholar]
  2. Banks B. M., Zetzel L., Richter H. S. Morbidity and mortality in regional enteritis. Report of 168 cases. Am J Dig Dis. 1969 Jun;14(6):369–379. doi: 10.1007/BF02239353. [DOI] [PubMed] [Google Scholar]
  3. Bergman L., Krause U. Crohn's disease. A long-term study of the clinical course in 186 patients. Scand J Gastroenterol. 1977;12(8):937–944. doi: 10.3109/00365527709181353. [DOI] [PubMed] [Google Scholar]
  4. De Dombal F. T., Burton I. L., Clamp S. E., Goligher J. C. Short-term course and prognosis of Crohn's disease. Gut. 1974 Jun;15(6):435–443. doi: 10.1136/gut.15.6.435. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. 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]
  6. 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]
  7. 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]
  8. Gump F. E., Sakellariadis P., Wolff M., Broell J. R. Clinical-pathological investigation of regional enteritis as a guide to prognosis. Ann Surg. 1972 Aug;176(2):233–242. doi: 10.1097/00000658-197208000-00020. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Homan W. P., Dineen P. Comparison of the results of resection, bypass, and bypass with exclusion for ileocecal Crohn's disease. Ann Surg. 1978 May;187(5):530–535. doi: 10.1097/00000658-197805000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. KIEFER E. D., MARSHALL S. F., BROLSMA M. P. The management of chronic regional ileitis. Gastroenterology. 1950 Jan;14(1):118–130. [PubMed] [Google Scholar]
  11. 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]
  12. Kyle J. Prognosis after ileal resection for Crohn's disease. Br J Surg. 1971 Oct;58(10):735–737. doi: 10.1002/bjs.1800581006. [DOI] [PubMed] [Google Scholar]
  13. 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]
  14. The course and prognosis of ulcerative colitis: Part II Long-term prognosis. Gut. 1963 Dec;4(4):309–315. doi: 10.1136/gut.4.4.309. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Truelove S. C., Pena A. S. Course and prognosis of Crohn's disease. Gut. 1976 Mar;17(3):192–201. doi: 10.1136/gut.17.3.192. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. VAN PATTER W. N., BARGEN J. A., DOCKERTY M. B., FELDMAN W. H., MAYO C. W., WAUGH J. M. Regional enteritis. Gastroenterology. 1954 Mar;26(3):347–450. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES