The clinical course of fistulating Crohn's disease

Details

Serval ID
serval:BIB_7EA2306CFA2F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The clinical course of fistulating Crohn's disease
Journal
Alimentary Pharmacology and Therapeutics
Author(s)
Bell  S. J., Williams  A. B., Wiesel  P., Wilkinson  K., Cohen  R. C., Kamm  M. A.
ISSN
0269-2813 (Print)
Publication state
Published
Issued date
05/2003
Volume
17
Number
9
Pages
1145-51
Notes
Journal Article --- Old month value: May 1
Abstract
AIM: To determine the clinical characteristics, management and outcome of Crohn's fistulas from the time of first presentation. METHODS: Patients treated for fistulas 6 years previously were assessed for disease demographics, fistula characteristics and treatment from first presentation to final follow-up. RESULTS: Eighty-seven patients with active Crohn's fistulas were evaluated. The median age was 35 years and the median duration of Crohn's disease was 8 years at study entry. Disease was ileo-colonic or colonic in 85%, and 65% had rectal involvement. A single fistula was present in one-third and multiple fistulas in two-thirds; 65% of fistulas were perianal; 80% of fistulas were complex. After a median follow-up from the last treatment of 5.9 years, 68% of patients showed healing of all fistulas, 18% showed healing of some fistulas and 14% showed no healing of fistulas. The fistula site did not influence healing. Perianal and recto-vaginal fistulas took a median of 2.6 years to heal. Half of the complex fistulas required a stoma, resection or proctectomy. CONCLUSIONS: Healing is usually achieved. However, morbidity is great and healing is slow. Proctectomy is required in one-fifth of patients, and perineal healing is often slow. Defining the perianal fistula anatomy as complex or simple determines the likelihood of healing and the type of surgical approach required.
Keywords
Adult Aged Aged, 80 and over Cohort Studies Colonic Diseases/*complications/therapy Crohn Disease/*complications/therapy Disease Progression Female Humans Ileal Diseases/*complications/therapy Intestinal Fistula/*complications/therapy Male Middle Aged Rectal Diseases/*complications/therapy Treatment Outcome Wound Healing
Pubmed
Web of science
Create date
25/01/2008 16:12
Last modification date
20/08/2019 14:39
Usage data