Crohn's disease (CD) is a nonspecific chronic intestinal inflammatory disease with unknown etiology. The course of CD is persistent and recurrent. In the progress, CD can come with many complications such as obstruction, fistula formation, perforation, and hemorrhage. The early diagnosis, treatment, and the time of the surgery for CD pose a big controversy and challenge. There was a female patient diagnosed as Crohn's disease with severe complication in department of Gastroenterology of the Third Xiangya Hospital, Central South University.  We reported the diagnosis and treatment on this patient. The choice for the medicine and surgury was discussed.
Crohn Disease ; complications ; diagnosis ; therapy ; Female ; Humans

Colon cancer is the most serious intestinal complication in patients with Crohn's disease. Although an association between Crohn's disease and colon cancer has not been clearly defined, a number of studies in western countries reported an increased rate of colon cancer in patients with Crohn's disease. In Korea, Crohn's disease is rare when compared to western countries, and only a single case of colon cancer associated with Crohn's disease has been reported. We recently experienced a 66-year-old women with colon cancer associated with Crohn's disease.
Aged ; Colonic Neoplasms/complications/*diagnosis ; Crohn Disease/*complications ; Female ; Humans

In Crohn's disease, neurologic complications such as cerebrovascular accident, headache, peripheral neuropathy have been reported sporadically. The pathogenesis of these neurologic complications is still unknown and controversial. We experienced a 22-year-old man, with Crohn's disease accompanied by optic neuritis. Loss of visual acuity was developed during the worsening course of enterocutaneous fistula. After high dose steroid treatment, his visual acuity and neurologic symptoms improved immediately.
Adult ; Crohn Disease/*complications/drug therapy/pathology ; Humans ; Intestinal Fistula/complications ; Male ; Optic Neuritis/*complications/diagnosis

OBJECTIVETo investigate the diagnosis and treatment of patients with Crohn disease (CD) complicated with gastrointestinal fistulae.

METHODSClinical data of sixty-two cases with CD complicated with gastrointestinal fistula e from 1978 to 2004 were analyzed.

RESULTSThese were 68 external fistulae in 6 2 patients including recurrent fistulae in 6 cases, internal fistulae in 8 cases . Twenty- seven fistulae were located in the terminal ileum and 21 fistulae wer e located in ileocolic anastomosis site. The main surgery included 14 ileocecal resections with primary anastomosis and 26 resections of original ileocolic anastomosis with fistula and re-anastomosis. The incidence of recurrence was lower (15.4% ) in patients with postoperative medication including sulfasalazine and immunomodulator than that (34.8% ) in patients without postoperative immunomodulator,but the recurrence time was longer [(40+/- 17) months] in patients with postoperative medication than that [(8+/- 3)months] in the patients without postoperative specific medication.

CONCLUSIONSMost CD fistulae are external fistulae,most of the external fistulae are treated by resection of the fistula and anastomosis. Specific medication including sulfasalazine,mesalamine and immunomodulators should be used to prevent postoperative complications and CD recurrence.

Adult ; Crohn Disease ; complications ; diagnosis ; surgery ; Female ; Humans ; Intestinal Fistula ; complications ; diagnosis ; surgery ; Male ; Middle Aged

BACKGROUND/AIMS: The aim of this study was to evaluate the clinical characteristics and course of Korean patients with Crohn's disease (CD). METHODS: A total of 113 patients who were newly diagnosed as having CD at the Asan Medical Center between October 1989 and December 2001 were included. RESULTS: The male to female ratio was 1.9:1 and the mean age at diagnosis was 24.2 +/- 7.8 years. The disease location was the small bowel in 19.5%, the large bowel in 11.5%, and the both small and large bowels in 69.0% of the patients. Empirical anti-tuberculous medications were administered to 53 cases (46.9%). Major complications of CD were intestinal obstruction (25.7%) and perianal fistula (42.5%). The cumulative remission rate was 75.7% at 1 year and 80.7% at 3 years from diagnosis. The cumulative relapse rate was 30.7% at 1 year and 53.0% at 3 years from remission. The cumulative operation rate was 11.5% at 1 year and 13.1% at 3 years from diagnosis. CONCLUSIONS: There are no differences in the remission and recurrence rates between Korean and Western patients with CD. Although the cumulative operation rate seems to be lower in Korea than in Western countries, the cause of the difference is uncertain. Further studies are needed to determine the characteristics of CD in Korea.
Adolescent ; Adult ; Crohn Disease/complications/*diagnosis/therapy ; English Abstract ; Female ; Humans ; Korea ; Male ; Remission Induction

The purpose of this study is to review the operative management and outcome of operation for Crohn's disease. The medical records of 17 patients who underwent operations due to Crohn's disease at Seoul National University Children's Hospital from January of 1988 to June of 2005 were reviewed and retrospective study was carried out. The male-to-female ratio was 1.8: 1. The median age at the onset of symptom and the time of diagnosis was 9 years 6 months and 11 years 6 months respectively. The median interval time from diagnosis to operation was 2 years and 1 month (0 month~8 years). Ileocolic or ileocecal region was the most common site of involvement. The indications of operation were intractable symptoms (8 cases) and obstruction or stricture (7 cases). The median postoperative hospitalized days were 14.4 days (8~35 days). Five patients (29%) experienced postoperative complications. Symptom free state or symptom relief was observed in 11 cases after surgery and 6 cases had wax and wane course of aggravation and improvement. In pediatric Crohn's disease patients who present with intractable symptoms despite medical treatment or develop surgical complications, symptom free state or symptom relief can be achieved by minimal resection of involved lesion.
Child* ; Constriction, Pathologic ; Crohn Disease* ; Diagnosis ; Humans ; Medical Records ; Postoperative Complications ; Retrospective Studies ; Seoul

Adult ; Crohn Disease ; complications ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; Hemoperitoneum ; diagnosis ; etiology ; Humans ; Wounds, Nonpenetrating ; diagnosis ; etiology

A psoas abscess (PA) is a rare clinical entity but is potentially serious condition which presents diagnostic and therapeutic challenges. The diagnosis is frequently delayed due to its variable and nonspecific features and occult clinical course. The delay in diagnosis and treatment of PA is the major poor prognostic factor. We describe herein a case of the sterile psoas abscess complicating Cronh's disease which presented as hip flexion contracture. A 29-year-old man, at remission stage of CD involving ileocolic segment, was admitted due to pain from hip contracture. He had no bloody diarrhea and no abdominal pain. PA was confirmed by abdominal ultrasound. PA with hip contracture was completely treated with surgical excision, irrigation, drainage, and antibiotics. PA was sterile and there was no evidence of a fistulous communication from the bowel. Once suspected, aggressive diagnostic work up and definitive operative intervention is needed.
Adult ; Crohn Disease/*complications/drug therapy ; Diagnosis, Differential ; Drainage ; Hip Contracture/complications/*diagnosis/surgery ; Humans ; Male ; Psoas Abscess/*diagnosis/etiology/ultrasonography ; Tomography, X-Ray Computed

Anal fistula is the most common perianal lesion in Crohn disease (CD), which usually is complicated and difficult to treat, and has a high recurrence rate and serious influence on the quality of life of patients. Inaccurate or incomplete intervention may result in irreversible damage. In order to achieve the best outcome, an optimal disease assessment is crucial. Many imaging modalities are useful for the evaluation of perianal fistulas in CD, which may help confirm the diagnosis, accurately classify the disease, plan the most suitable treatment, and monitor the efficacy. Magnetic resonance imaging (MRI), endoscopic ultrasonography (EUS) and anal endosonography (AES) are considered to be the suitable options for evaluation of the initial perianal fistula, both in terms of sensitivity and specificity, while MRI is more suitable for monitoring the curative efficacy. Fistulography (by X ray or CT) is generally less applied due to inferior soft tissue performance, radiation exposure, etc. This paper reviews the various imaging modalities, analyzes their advantages and disadvantages in order to assist clinicians in selecting the most appropriate examination individually.
Crohn Disease ; complications ; Endosonography ; Humans ; Magnetic Resonance Imaging ; Multimodal Imaging ; Quality of Life ; Rectal Fistula ; diagnosis ; etiology ; Sensitivity and Specificity

No abstract available.
Adult ; Constriction, Pathologic ; Crohn Disease/*complications ; Endoscopy, Gastrointestinal ; Humans ; Ileal Diseases/*diagnosis/etiology/pathology ; Ileum/pathology ; Male