[Clinical aspects and course of Crohn disease]

The influence of clinically observable criteria on the course of disease was investigated in 150 patients, 72 men and 78 women, with morbus Crohn who could be followed for an average period of 6.6 years (8-348 months). In 29 patients (19%), the small intestine only was involved, in 31 patients (21%) the colon, and in 90 patients (60%) both the small intestine and colon. During the observation period 71 patients (47%) developed fistulae and 55 (37%) extra-intestinal manifestations. The patients were admitted to hospital on a total of 466 occasions (3.1 times per patient), and 199 operations (1.3 times per patient) were carried out. There were significantly more extra-intestinal manifestations in the colon cases (P less than 0.01) and of admissions and operations in the small intestine-colon cases (P less than 0.001), whereas patients with isolated involvement of the small intestine underwent significantly fewer operations (P less than 0.001). In addition, significant positive correlations existed between the appearance of fever and fistulae (P less than 0.001) and between the number of operations within the first 2 years and the number of subsequent operations (P less than 0.001).