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Jejunal Crohn's disease is associated with a higher postoperative recurrence rate than ileocaecal Crohn's disease


  • This paper has been presented at the American Society of Colon and Rectal Surgeons, New Orleans, USA in June 2003 and at the Association of Coloproctology of Great Britain and Ireland, Edinburgh, UK in July 2003.

Professor M. R. B. Keighley, Department of Surgery, Queen Elizabeth Hospital, Edgbaston, Birmingham, B15 2TH, UK.


Objective  Crohn's disease is a chronic inflammatory, panintestinal disease of uncertain aetiology. The recurrence rate of Crohn's disease, often taken as the time when further surgical procedure is undertaken, has been reported to be as high as 76% in 10 years. The site of the disease has not yet been associated with the recurrence rate of Crohn's disease. The aim of the study was to compare the outcome of patients who were surgically treated for jejunal Crohn's disease to those whose diseases was confined to the ileocaecal region.

Method  The information was tracked from our database of 724 surgically treated Crohn's disease patients between 1943 and 2002. Twenty-eight patients with jejunal Crohn's disease at their first operation (12 jejunum alone, 16 also involving other sites) were identified. For each of these patients, 3 patients with ileocaecal Crohn's, matched for age, sex, and smoking habits (n = 84) were identified as controls.

Results  The median age in both groups was 21 years (range 16–52 years) with a median follow-up period of 19 years. The 3, 5 and 10 years re-operation rate for the groups with jejunal disease were 43%, 50% and 61% compared to 22%, 30% and 51% with ileocaecal disease, respectively.

Conclusions  The presence of jejunal Crohn's disease is associated with a higher rate of early disease recurrence compared to ileocaecal disease but long-term recurrences rate do not differ significantly.