PMID: 16505755Mar 1, 2006Paper

Intestinal perforation in Crohn's disease. Factors predictive of surgical resection

Gastroentérologie Clinique Et Biologique
Hélène BrihierJacques Cosnes

Abstract

New medical therapeutic options challenge the usual surgical management of Crohn's disease patients with intestinal perforation. To determine factors predictive of surgery for perforation in Crohn's disease and define a group of patients that may benefit from non-surgical treatment. One hundred and sixty-two patients (69 males, 93 females, mean age 39) with perforated Crohn's disease (fistula, abscess, inflammatory mass) between January 1995 and September 2003 were studied retrospectively. One hundred and fifty-one patients (93%) underwent surgery: 70 had planned surgery and 81 had surgery for symptomatic deterioration. At two years, the cumulative probability of intestinal resection was 0.89 +/- 0.03, and the cumulative probability of unplanned intestinal resection was 0.72 +/- 0.05. Predictive factors of unplanned surgery were elevated platelet count (adjusted hazard ratio 3.15; 95% CI 2.21-4.50) and absence of fistula (adjusted hazard ratio 3.14; 95% CI 2.48-3.99). The rate of postoperative complications, the need for a stoma, and the length of bowel resection were not significantly different whether the surgery was planned or not. A significant proportion of patients with intestinal perforation complicating Crohn's disease,...Continue Reading

References

Jan 11, 1991·Annals of Surgery·M B RibeiroA H Aufses
May 1, 1988·AJR. American Journal of Roentgenology·R E LambiaseR A Haas
Nov 1, 1973·Gut·D M SteinbergJ Alexander-Williams

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Citations

Sep 28, 2007·Pediatric Radiology·F RypensL Garel
Aug 11, 2007·Diseases of the Colon and Rectum·Scott A StrongUNKNOWN Standards Practice Task Force of The American Society of Colon and Rectal Surgeons
Dec 10, 2009·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Ker-Kan TanRichard Sim
Mar 6, 2012·Gut·Jacques CosnesPhilippe Seksik
May 12, 2007·Gastroenterología y hepatología·Javier P Gisbert, Fernando Gomollón

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