대한대장항문학회

Purpose : Crohn's disease is chronic, nonspecific inflammatory process and the incidence is<br>becoming larger recently. The authors studied the clinical course of the Crohn's disease by<br>reviewing the clinical characteristics, anatomical distribution, operative indications, operative<br>procedures and postoperative results. Methods : We reviewed medical records of 30 patients<br>who had treatment at the Chonbuk national university hospital from June 1988 to December<br>1997. We analyzed their age, sex distribution, clinical symptoms, anatomical distribution,<br>operative indication, operative procedure, postoperative recurrence rate and postoperative<br>results. Results : Sex ratio was 1.5：1 (male：female) and average age of onset was 33 year.<br>Thirteen patients (43%) underwent operation but there was no remarkable difference between<br>the groups that received operation and that had medical treatment. Abdominal pain and<br>diarrhea were common but there were no extraintestinal symptoms. The most common site of<br>involvement was ileocecum and the next was small intestine, followed by large intestine.<br>Intestinal obstruction was the most common indication for surgery and fistula, abscess<br>formation and palpable abdominal mass in order. Three cases out of 13 patients who had<br>undergone primary resection needed second operation, and 2 cases of the 3 recurrent cases<br>underwent the third operation. During the follow up period, there were two cases of<br>re-operation due to anastomotic leak or ileus. The patient who received the third operation<br>(right hemicolectomy, retroperitoneal abscess drainage and jejunal resection) died of<br>anastomotic leak, enterocutaneus fistula, sepsis and respiratory failure. Conclusions : The<br>incidence of Crohn's disease in Korea is gradually increasing and the disease has been<br>challenging problems to most surgeons for its frequent surgical indication, high recurrence<br>rate, complication and poor surgical results. The above results suggest that Crohn's disease<br>needs follow-up even after the operation.<br>