Summary
Fifty patients with Crohn's disease were studied endoscopically 6 weeks to 6 months
(median 9 weeks) after ileocecal or ileocolonic resection for evidence of non-resected
abnormality. Only 8 of the 50 patients were endoscopically free of abnormalities.
Microscopic examination of the surgical specimen revealed inflammatory pathology at
the site of resection line in 30 patients. Of the latter, 27 had endoscopic lesions
at the anastomosis or in the “neoterminal” ileum. Of the 42 patients with endoscopic
lesions only 8 had minor biochemical abnormalities. This study suggests that the well
known reappearance of inflammatory activity after resection, especially at and proximal
to the anastomosis, develops from foci of remaining inflammation and should be considered
as recrudescence of the disease rather than true recurrence
Key words:
Crohn's disease - Ileocecal resection - Recurrence - Recrudescence - Endoscopic lesions
