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  • Title: Perforating and nonperforating Crohn's disease. An unpredictable guide to recurrence after surgery.
    Author: McDonald PJ, Fazio VW, Farmer RG, Jagelman DG, Lavery IC, Ruderman WB, Easley KA, Harper PH.
    Journal: Dis Colon Rectum; 1989 Feb; 32(2):117-20. PubMed ID: 2914525.
    Abstract:
    Four hundred eighty-six patients who have had resections for Crohn's disease at the Cleveland Clinic were reviewed. The patients were categorized by indication for surgery into three groups: perforating (P) (135 patients), nonperforating (NP) (278 patients), and miscellaneous (M) (77) patients. One hundred ninety-four patients had two or more resections and 56 underwent a third resection. Patients were no more likely to have the same indication for surgery at the time of the second resection (P = 25 percent; NP = 44 percent; M = 57 percent) or the third resection (P = 11 percent; NP = 65 percent; M = 55 percent). There was also no difference in the interval between resections for the P and NP groups. The lack of agreement between resections suggests that the categorization of patients into P and NP groups does not facilitate prediction of the nature of recurrent disease. The concept of aggressive perforating and indolent nonperforating Crohn's is not substantiated by this study.
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