Surgical complications and skin test reactivity in patients with inflammatory bowel disease

One hundred patients with inflammatory bowel disease were admitted to the Mount Sinai Hospital, New York, for surgical treatment. These patients were studied to evaluate the association between skin test reactivity and postoperative complications. Skin tests were performed prior to surgery using four recall antigens. Sixty patients were found to be anergic. The postoperative complication rate was significantly higher in the anergic patients when compared with those patients who were able to react to at least one skin test antigen. Twenty-seven anergic patients had 34 complications and almost 60% of these complications were of the septic type. Only 11 patients who responded to the skin tests had postoperative complications. Complications in the anergic patients required longer hospitalization and more frequent operative correction. There were no deaths in this series. Although anergic patients with inflammatory bowel disease are prone to experience septic complications, their prognosis appears to be better than the morbidity and mortality reported in the literature for anergic patients with other conditions.