Davidson J T, Sawyers J L
Am Surg. 1982 Jan;48(1):16-9.
Crohn's disease may involve any portion of the alimentary tract and is being seen with increasing frequency. This report details the results in 135 patients undergoing 214 operations for Crohn's disease. There were 68 males and 67 females ranging in age from 10 to 76 years. Thirty-two per cent of patients underwent multiple operations. The recurrence rate was 53 per cent, with an average follow-up of four years. The common sites of involvement by Crohn's disease were ileocolic (36%), ileum (31%), and perianal (16%). Patients were also managed for Crohn's disease of the esophagus, stomach, and duodenum. Our patient patient with Crohn's disease of the esophagus is very unique, as only 20 such cases have been reported. Primary resection of diseased bowel with re-anastomosis is the preferred operative management. A bypass procedure was done in only four patients. The mortality rate was 2.2 per cent. The incidence of carcinoma is increased in patients with small bowel regional enteritis. A recent literature review reports 36 patients with adenocarcinoma of the small bowel affected with regional enteritis. Three of the patients developed an adenocarcinoma in association with Crohn's disease.
克罗恩病可累及消化道的任何部位，且其发病率正日益增加。本报告详细介绍了135例因克罗恩病接受214次手术的患者的情况。其中男性68例，女性67例，年龄在10至76岁之间。32%的患者接受了多次手术。复发率为53%，平均随访时间为四年。克罗恩病常见的受累部位为回结肠（36%）、回肠（31%）和肛周（16%）。患者还接受了食管、胃和十二指肠克罗恩病的治疗。我们患有食管克罗恩病的患者非常独特，因为仅有20例此类病例被报道过。对病变肠段进行一期切除并重新吻合是首选的手术治疗方法。仅4例患者进行了旁路手术。死亡率为2.2%。小肠局限性肠炎患者患癌的几率会增加。最近的一篇文献综述报道了36例患有局限性肠炎的小肠腺癌患者。其中3例患者在患克罗恩病的同时发生了腺癌。
