Tytgat G N, Mulder C J, Brummelkamp W H
Academic Medical Center, University of Amsterdam.
Endoscopy. 1988 Sep;20(5):260-2. doi: 10.1055/s-2007-1018188.
Fifty patients with Crohn's disease were studied endoscopically 6 weeks to 6 months (median 9 weeks) after ileocecal or ileocolonic resection for evidence of non-resected abnormality. Only 8 of the 50 patients were endoscopically free of abnormalities. Microscopic examination of the surgical specimen revealed inflammatory pathology at the site of resection line in 30 patients. Of the latter, 27 had endoscopic lesions at the anastomosis or in the "neoterminal" ileum. Of the 42 patients with endoscopic lesions only 8 had minor biochemical abnormalities. This study suggests that the well known reappearance of inflammatory activity after resection, especially at and proximal to the anastomosis, develops from foci of remaining inflammation and should be considered as recrudescence of the disease rather than true recurrence.
对50例克罗恩病患者在回盲部或回结肠切除术后6周~6个月（中位时间9周）进行内镜检查，以寻找未切除异常的证据。50例患者中只有8例内镜检查未发现异常。手术标本的显微镜检查显示，30例患者在切除线部位存在炎症病理改变。其中，27例在吻合口或“新末端”回肠有内镜下病变。42例有内镜下病变的患者中，只有8例有轻微的生化异常。本研究提示，切除术后炎症活动的再次出现，尤其是在吻合口及其近端，是由残留炎症病灶发展而来，应被视为疾病的复发而非真正的再发。
