Mortensen N J, Ritchie J K, Hawley P R, Todd I P, Lennard-Jones J E
Br J Surg. 1984 Oct;71(10):783-4. doi: 10.1002/bjs.1800711016.
Acute Crohn's disease of the colon requiring emergency surgery is uncommon, but may be increasing in frequency. Between 1954 and 1981, 215 patients had surgery for acute inflammatory bowel disease at St. Mark's Hospital, and of these 18 had acute Crohn's colitis. There was one postoperative death, and the remaining patients were followed up for an average of 8 years. Ten patients had toxic dilation, two a toxic dilation with free perforation, three had perforation without dilatation and in three surgery was required for an acute deterioration. Surgical treatment included proctocolectomy (one), colectomy and ileostomy (fourteen), colectomy and ileorectal anastomosis (two) and defunctioning ileostomy alone (one). Subsequent rectal excision was necessary in ten of sixteen patients. Acute colonic Crohn's disease requiring surgery is less likely than ulcerative colitis to be amenable to restorative surgery despite a policy of rectal conservation.
需要急诊手术的急性结肠克罗恩病并不常见，但发病频率可能在增加。1954年至1981年间，215例患者在圣马克医院接受了急性炎症性肠病手术，其中18例患有急性结肠克罗恩病。术后有1例死亡，其余患者平均随访8年。10例出现中毒性扩张，2例伴有游离穿孔的中毒性扩张，3例无扩张的穿孔，3例因急性病情恶化需要手术。手术治疗包括全直肠结肠切除术（1例）、结肠切除术加回肠造口术（14例）、结肠切除术加回肠直肠吻合术（2例）和单纯去功能化回肠造口术（1例）。16例患者中有10例随后需要进行直肠切除术。尽管采取了保留直肠的策略，但与溃疡性结肠炎相比，需要手术的急性结肠克罗恩病更不太可能适合进行修复性手术。
