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Malignant colorectal strictures in Crohn's disease
Y Yamazaki1, M B Ribeiro, D B Sachar
1Department of Surgery, Mount Sinai School of Medicine, City University of New York, NY.
The American Journal of Gastroenterology
|July 1, 1991
Summary
Crohn's disease patients with colonic strictures have a high risk of developing colon cancer. Early detection through colonoscopy and biopsy is crucial for timely intervention and improved outcomes.
Area of Science:
- Gastroenterology
- Oncology
- Colorectal Surgery
Background:
- Crohn's disease (CD) frequently involves the colon, leading to complications like colonic strictures.
- Colonic strictures in CD patients are associated with an increased risk of malignancy.
Purpose of the Study:
- To determine the frequency and characteristics of colonic strictures in Crohn's disease patients.
- To evaluate the association between colonic strictures and colorectal cancer in CD.
- To assess the diagnostic and therapeutic implications of colonic strictures in CD.
Main Methods:
- Retrospective review of 980 patients with Crohn's disease involving the colon admitted between 1959 and 1985.
- Identification and analysis of 175 colonic strictures in 132 patients.
- Comparison of characteristics and outcomes between benign and malignant strictures.
Main Results:
- 13.5% of CD patients developed colonic strictures; frequency was higher in colitis than ileocolitis.
- 10 malignant strictures were identified in 9 patients, representing 6.8% of strictures.
- Malignant strictures were shorter, diagnosed at a higher age, and increased with disease duration compared to benign strictures.
- Cancer frequency was significantly higher in patients with strictures (6.8%) than without (0.7%).
Conclusions:
- Colonic strictures in Crohn's disease patients carry a significant risk of malignancy.
- Colonoscopy with biopsy is essential for evaluating colonic strictures in CD.
- Surgical intervention should be considered for strictures that cannot be fully assessed endoscopically.