[Management of Crohn's disease]

Our therapeutic management to Crohn's disease was analyzed retrospectively. Among 17 cases with Crohn's disease, 14 (82%) were operated. Operative indications were due to obstruction (7), perforation (2), fistula (2), stenosis (2) and intractability (1). Postoperative recurrence was developed in 8 out of 14 (57%) and 4 were reoperated. Most of recurrent lesions were around the previous anastomosis. Operation per se does not cure the Crohn's disease but operation should be indicated when complicated obstruction, fistula and perforation. Nutritional treatment has been also performed 8 times. Crohn's disease activity index (CDAI) was decreased in all but one. In individual item of CDAI, frequency of bowel movement, abdominal pain and general status were improved but items such as anal lesion, fistula and fever were not improved. CDAI values were turned to remission value in all of cases with complicated stenotic lesions, but it remained in active stage in all cases with complicated fistula, obstruction and abscess. Nutritional treatment seemed less effective in cases complicated fistula, obstruction and abscess.