Radiologic appearance of recurrent ileal Crohn disease.

Area of Science:

• Gastroenterology
• Radiology
• Surgical Oncology

Background:

• Postoperative recurrence of Crohn disease is frequent.
• Radiologic patterns of recurrent ileal Crohn disease are not well-established.
• This study aimed to compare radiologic patterns in de novo and recurrent Crohn disease.

Purpose of the Study:

• To compare the radiologic findings of de novo ileal Crohn disease with those of recurrent ileal Crohn disease after surgery.
• To identify characteristic radiologic features distinguishing recurrent Crohn disease.

Main Methods:

• Retrospective review of small bowel examinations in 105 patients with Crohn disease.
• Comparison of radiologic patterns between a control group (47 patients, no prior surgery) and a postoperative group (58 patients, with resections).

Main Results:

• 97% of postoperative patients showed anastomotic recurrence with proximal extension.
• No significant differences in distal ileal disease length or skip lesions between de novo and recurrent disease.
• Recurrent disease showed higher frequencies of strictures and lower frequencies of mucosal thickening, ulceration, sacculation, and masses compared to de novo disease.

Conclusions:

• Postoperative ileal Crohn disease predominantly recurs at the anastomosis with proximal extension.
• Significant differences exist in radiologic disease patterns between de novo and recurrent ileal Crohn disease.