The operative treatment of Crohn's disease in childhood

Fifteen pediatric patients have been presented who required operative treatment for Crohn's disease. This disease is associated with severe side-effects in children, especially maturation and growth arrest. There are clear indications for surgical treatment: fistula, chronic obstruction, hemorrhage and perforation. Failure to grow, when associated with obstruction of the small intestine, is an urgent indication for operation. From our observations, we conclude that growth arrest in these patients occurs because of malnutrition. In a majority of patients, chronic obstruction of the small intestine contributes significantly to this malnutrition. Operative treatment is one of conservative resection, and the operative mortality is nil. The majority of patients with growth arrest will grow postoperatively. Operative treatment of Crohn's disease is carried out for its complications, and treatment is quite effective in relieving these complications, although the disease itself may persist.