[Malignant degeneration of the intestine in Crohn's disease]

A woman suffering more than ten years with Crohn disease, makes one day a small intestinal obstruction. She undergoes a laparotomy in which a resection of 30 cm terminal ileum is done. Surprisingly the anatomo-pathologic diagnosis is adenocarcinoma between the Crohn's inflammatory lesions. Weedom and Greenstein have proven that Crohn disease and colon carcinoma are related in their follow-ups. But to find such a relationship between Crohn and carcinoma of the small intestine tumours is very small: +/- 0,3/100.000 in a year and so the cases in literature too. We have found 38 cases with enough information. This people with Crohn and carcinoma of the small intestine have an age of 43 years and more than 10 years Crohn symptoms before tumour was found. The tumours are localized in more than 70% in the ileum; 85% are adenocarcinoma. Such differences in localization, age and anatomopathology between Crohn's patients and a normal population let us presume that malign degeneration in Crohn disease is more than accidentally. A casual connection can't be given. For therapeutic use a resection is to prefer because many dysplasias are found in bypass segments.