Long-term Outcomes of Crohn's Disease―Prediction of Progression to Intestinal Complications Kiyonori Kobayashi 1 , Azuma Murata 1 , Yasuhiro Ishiguro 1 , Masaru Yamagata 1 , Hitomi Takeuchi 1 , Satomi Haruki 1 , Kaoru Yokoyama 1 , Miwa Sada 1 , Tomoe Katsumata 1 , Katsunori Saigenji 1 1Department of Gastroenterology, Kitasato University East Hospital, Sagamihara, Japan Keyword: Crohn病 , 長期経過 , 腸管合併症 pp.1859-1868
Published Date 2007/12/25
DOI https://doi.org/10.11477/mf.1403101240
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 We examined whether progression to intestinal complications such as strictures and fistulas can be predicted on the basis of radiographic and endoscopic findings of the intestine diagnosed at first examination in 142 patients with Crohn's disease who were followed-up for 5 years or longer without undergoing surgery. Among 106 patients with no intestinal complications at first examination, 34 (32%) had progression to intestinal complications during follow-up. The development of complications was frequently associated with a marked cobblestone-appearance and fissuring ulcers at first examination. Among 46 patients who had intestinal strictures at first examination, 8 (17%) had progression to fistula during follow-up. In patients with fistula, a long stricture extending for at least 3 cm was frequently seen at first examination, and continued home enteral nutrition was less common than in patients without fistula. In conclusion, physicians should bear in mind that patients who have a marked cobblestone-appearance, fissured ulcers, or a long intestinal stricture on endoscopic and radiographic findings at first examination are at high risk for progression to other intestinal complications.

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