Surgical risks in Crohn’s patients

  Crohn’s disease is an inflammatory disease of the intestine of unknown origin that can occur anywhere in the gastrointestinal tract, but is more prevalent in the terminal ileum and right hemicolectum. The disease and chronic nonspecific ulcerative colitis are collectively referred to as inflammatory bowel disease (IBD). The clinical manifestations of this disease are abdominal pain, diarrhea, and intestinal obstruction, accompanied by fever, nutritional disorders, and other extraintestinal manifestations. The course of the disease is prolonged, recurrent and not easily curable. The disease is also known as limited enteritis, limited ileitis, segmental enteritis and granulomatous enteritis.  There is no cure, and many patients develop complications that require surgery, and the recurrence rate after surgery is high. The recurrence rate of this disease is related to the extent of the lesion, the strength of the disease invasion, the prolongation of the disease, and the increase in age, and the mortality rate increases.  A recent Japanese retrospective cohort study of 50 cases of Crohn’s found that: 1. strictures and fistulas gradually increase with the duration of the disease and develop in half of the patients after 5 years; 2. 50% of patients requiring surgery after 10 years; 3. the risk of first surgery increases if the following factors are present at the time of diagnosis: smoking, upper gastrointestinal involvement, strictures, penetrating lesions, and moderate to severe stenosis of the jejunum.