A changing trend in the management of patients with newly diagnosed Crohn's disease
1Adelaide and Meath Hospital, Tallaght/Trinity College, Dublin, Ireland. asgharqasim@yahoo.co.uk
Background:
Epidemiologic shift with rising incidence of Crohn's disease (CD) has been reported in recent studies.
Aims:
To determine disease behaviour and therapeutic interventions undertaken in newly diagnosed patients with CD.
Methods:
Patients diagnosed with CD between January 2006 and June 2008 were included. Disease type, location, degree of involvement and type of therapeutic interventions were recorded.
Results:
A total of 78 patients were included. Colonic, ileo-colonic, terminal ileal and isolated small bowel disease were present in 37, 27, 9 and 5 patients, respectively. Disease phenotype was inflammatory, stenosing and fistulising in 42, 30 and 6 patients, respectively. Surgery was required in 22 patients, including right hemicolectomy (n = 8), subtotal colectomy (n = 4), segmental colonic resection (n = 2), segmental small bowel resection (n = 2), appendectomy (n = 2) and perianal surgery (n = 4). Fourteen patients underwent surgery at the time of diagnosis. Laparoscopic surgery was performed in 14 patients.
Conclusions:
A significant proportion of newly diagnosed patients with CD underwent surgical intervention on their first admission to hospital. This may signify a changing trend in the management approach.
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