Clinical Subtypes of Crohn's Disease According to Surgical Outcome

Scott E. Greenway, Michael A. Buckmire, Carlos Marroquin, Lora Jadon, Rolando Rolandelli

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Patients with Crohn's disease are typically classified into perforator or nonperforator groups. The perforator group includes those who present with acute perforation, fistulas, or abscess formation. The non-perforator group presents with stricture, obstruction, or unresponsiveness to medical therapy. Our purpose was to investigate whether perianal disease constitutes a separate predictor of surgical outcome. The form of presentation was classified as perforator, nonperforator, or perianal disease in 91 patients undergoing 232 operations for Crohn's disease. Those with perforating complications presented with the highest Crohn's Disease Activity Index, followed by those with nonperforating complications, and then the perianal disease group. However, the perianal disease group appeared to have the most rapid rate of recurrence and subsequent surgery, followed next by the perforator, and then the nonperforator group. Recurrence rate and subsequent operation intervals for the perforator group appeared to lengthen when those patients were treated with steroids and/or immunosuppressants, as compared to nonsteroidal and/or antimicrobial agents. Recurrence rate and subsequent operation intervals appeared to lengthen for the nonperforator and perianal disease groups when they were treated with nonsteroidal and/or antimicrobial therapy, as compared to steroids and/or immunosuppressants. Our data indicate that perianal disease, as a form of presentation of Crohn's disease, has independent predictive value, although this is not accurately reflected by the Crohn's Disease Activity Index.

Original languageEnglish (US)
Pages (from-to)145-151
Number of pages7
JournalJournal of Gastrointestinal Surgery
Volume3
Issue number2
DOIs
StatePublished - Jan 1 1999
Externally publishedYes

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Crohn Disease
Immunosuppressive Agents
Recurrence
Steroids
Anti-Infective Agents
Abscess
Fistula
Pathologic Constriction
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology

Cite this

Greenway, Scott E. ; Buckmire, Michael A. ; Marroquin, Carlos ; Jadon, Lora ; Rolandelli, Rolando. / Clinical Subtypes of Crohn's Disease According to Surgical Outcome. In: Journal of Gastrointestinal Surgery. 1999 ; Vol. 3, No. 2. pp. 145-151.
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Clinical Subtypes of Crohn's Disease According to Surgical Outcome. / Greenway, Scott E.; Buckmire, Michael A.; Marroquin, Carlos; Jadon, Lora; Rolandelli, Rolando.

In: Journal of Gastrointestinal Surgery, Vol. 3, No. 2, 01.01.1999, p. 145-151.

Research output: Contribution to journalArticle

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