Crohn's disease (CD), one of the major forms of idiopathic inflammatory bowel disease (IBD), is thought to be related to genetic susceptibility coupled with environmental factors. A positive family history is the strongest risk factor for the development of CD. The 10-fold increase in the familial risk of CD strongly suggests that these disorders have a genetic background. The prevalence of IBD in Asian populations is lower than in Western populations, which may be due to genetic influences, environmental factors, or a combination of both. In a Korean study, only 0.25% of parents had IBD in CD probands and all of them had ulcerative colitis. The term of familial CD was used only for those with one or more first-degree relatives with confirmed CD. There are few case reports about familial Crohn's disease in Korea. We report a case of familial CD that the father, the first degree relative was diagnosed as small bowel CD after confirming his son as having CD.
Child ; Colonoscopy ; Crohn Disease/*diagnosis/etiology/radiography ; Family ; Genetic Predisposition to Disease ; Humans ; Male ; Middle Aged ; Pedigree

China ; Colitis, Ulcerative ; epidemiology ; etiology ; Crohn Disease ; epidemiology ; etiology ; Humans ; Inflammatory Bowel Diseases ; epidemiology ; etiology ; Sweetening Agents ; adverse effects

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

BACKGROUND/AIMS: Cigarette smoking is the most significant environmental factor identified in inflammatory bowel disease (IBD). Smoking has a beneficial effect on ulcerative colitis (UC) patients. In contrast, Crohn's disease (CD) is associated with smoking, and a detrimental effect of smoking on the course of CD has been demonstrated. The aim of this study was to explore the prevalence in smoking in CD and UC at the time of diagnosis compared with the general population in a single center study. METHODS: Prevalence of smoking at the time of IBD diagnosis were compared between CD and UC patients in Kyung-Hee Medical Center with healthy general population at age-, gender-, and time period-adjusted rates. We investigated the smoking status of IBD patients at the time of diagnosis by telephone interview. There were 178 IBD patients (98 UC patients and 80 CD patients) between January 1995 and December 2004. RESULTS: The male to female ratio in CD and UC were 2:1 and 1:1.4, respectively. The onset of age was 28.2 years and 38.8 years, respectively. The prevalence of smoking was significantly lower in CD and UC patients than in the general population (CD; odds ratio 0.21, 95% confidence interval 0.12-0.41, p<0.001, UC; odds ratio 0.06, 95% confidence interval 0.03-0.14, p<0.001). After statistical adjustment for gender and age at the diagnosis of IBD, the odds ratio of a current smoker diagnosed as UC was 73% lower than that of CD (adjusted odds ratio 0.27, 95% confidence interval 0.12-0.59, p<0.001). In contrast, being a former smoker showed a risk of approximate 1.27-fold higher likelihood of having UC diagnosis (adjusted odds ratio 1.27, confidence interval 0.41-3.95, p=0.68). CONCLUSIONS: Cigarette smoking is protective against developing UC at any age, but is not associated with the development of CD in Korean population. Former smoking is not the high risk factor in developing UC.
Adult ; Colitis, Ulcerative/*prevention & control ; Crohn Disease/*etiology ; Female ; Humans ; Male ; Risk Factors ; *Smoking/adverse effects

OBJECTIVETo investigate the clinical characteristics and treatment strategy of lower extremity arterial occlusive disease in patients with Crohn's disease (CD).

METHODSClinical information of 9 cases suffering from lower extremity arterial occlusion and CD was investigated retrospectively.

RESULTSAll the cases were less than 50 years old and the most were females (8/9). Arterial occlusions occurred in either active (5/9) or inactive (4/9) stage of CD. Besides the arteries of lower extremities, other arteries could also be involved such as aorta, iliac artery, renal artery or mesentery artery. Seven cases had atherosclerotic imaging findings (4 had aortic plaques and 6 had iliac artery stenoses). Embolectomy or thromboendarterectomy were mostly performed. Four (44.4%) cases had recurrent lower limb ischemia.

CONCLUSIONSArterial occlusive disease is a rare extraintestinal manifestation of CD. A thorough inspection of aorta is necessary. Embolectomy is mostly preferred. Anticoagulation treatment is highly recommended after the operation.

Adult ; Arterial Occlusive Diseases ; etiology ; surgery ; Atherosclerosis ; etiology ; surgery ; Crohn Disease ; complications ; Embolectomy ; Female ; Humans ; Leg ; Male ; Thrombectomy ; Young Adult

Crohn disease (CD) is a chronic inflammatory disease involving the entire digestive tract and non-perianal fistula is the most serious surgical complication of CD. The goal of treatment is to cure intestinal fistula and intra-abdominal infection, restore the continuity of digestive tract, reduce postoperative recurrence, and improve the quality of life. Evaluation of nutritional status, especially during perioperative period, is important and nutrition support for malnutritional CD patients is necessary. Full assessment of non-perianal fistula and promotion of self-healing is the principal treatment, and surgical drainage combined with enteral nutrition may be a feasible treatment. Trocar puncture with sump drain is recommended to control intra-abdominal abscess. Surgical treatment of enterocutaneous fistula, enteroenteric fistula, enterovesical fistula or enterogynaecological fistula should be considered if medical treatment, nutrition support and surgical drainage fail. Laparoscopic surgery is recommended for patients with mild adhesion of non-perianal fistulating CD. Postoperative medical treatment and risk assessment should be carried out to reduce postoperative recurrence of CD and fistula.
Abdominal Abscess ; etiology ; therapy ; Consensus ; Crohn Disease ; complications ; diagnosis ; therapy ; Drainage ; Humans ; Quality of Life ; Rectal Fistula ; etiology ; therapy

OBJECTIVETo evaluate the role of nutritional status on serum immunoglobulins, body weight and postoperative infectious-related complications in patients with Crohn's disease receiving perioperative parenteral nutrition (PN).

METHODS32 patients with Crohn's disease receiving perioperative parenteral nutrition in our department between 1984 and 1994 were enrolled in this survey. 16 patients with loss of body weight in the range of 15%-30% were assigned to the malnutrition group, the other 16 patients with normal weight or loss of body weight less than 15% to the control group. Serum IgM, IgG and IgA levels were measured before and after PN by enzyme-linked immunosorbent assays. Liver function, body weight changes and postoperative complications were also analyzed.

RESULTSIgM levels were elevated before PN in both groups [control group: (133 +/- 16) mg/dl, malnutrition group: (139 +/- 41) mg/dl; normal value: (110 +/- 35) mg/dl; P = 0.04], decreased to normal value [(105 +/- 29) mg/dl, P = 0.02] in the malnutrition group while having no obvious changes in the control group [(129 +/- 13) mg/dl, P = 0.34]. No significant changes in concentrations of IgG and IgA were found (P in the range of 0.20-0.57). The average weight gain was 1.862 kg in malnutrition group [before PN: (45.8 +/- 8.9) kg, after PN: (48.0 +/- 8.8) kg; P = 0.005] and no significant changes in the control group [before PN: (55.6 +/- 6.1) kg, after PN: (56.3 +/- 6.0) kg; P = 0.46]. There was an increase in infectious complications in the control group (control group: 4 cases, 25%, malnourished group: 2 cases, 12.5%; P = 0.13).

CONCLUSIONSPerioperative parenteral nutrition ameliorated the humoral immunity, increased the body weight in patients with obvious malnutrition, whereas it had little value for those without or with mild malnutrition.

Adult ; Aged ; Body Weight ; Crohn Disease ; immunology ; surgery ; therapy ; Female ; Humans ; Immunoglobulins ; blood ; Male ; Malnutrition ; etiology ; Middle Aged ; Nutritional Status ; Parenteral Nutrition ; Pneumonia ; etiology ; Postoperative Complications ; etiology

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

No abstract available.
Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use ; Crohn Disease/*complications/*drug therapy ; Female ; Humans ; Intestinal Obstruction/*etiology ; Male