Shapiro P A, Peppercorn M A, Antoniolo D A, Joffe N, Goldman H
Am J Gastroenterol. 1981 Aug;76(2):132-7.
To determine the features of Crohn's disease in elderly patients we reviewed the charts, roentgenograms and pathology of patients with Crohn's disease admitted to our hospital from 1966 through 1979. Thirty-three patients (5.2% of the total) had the onset of symptoms and diagnosis made after age 60, including 18 (55%) with ileitis alone, 11 with colitis and four with ileocolitis. Six patients were seen, four with colitis and two with ileocolitis, with acute toxicity requiring early surgery. The clinical, radiographic and histologic characteristics of the disorder in older patients were otherwise similar to those described in younger patients. Differentiation of ischemic bowel disease and diverticulitis from Crohn's disease in such patients was difficult without reliance on histologic as well as clinical and roentgenographic features. Fifty-eight per cent of these older patients eventually required surgery, including 10 of 11 (91%) with colitis, two fo four with ileocolitis and seven of 18 (39%) with ileitis. The cumulative clinical recurrence rate, limited to patients with ileal disease, was 21% at nine years and 37% at 15 years.
为确定老年克罗恩病患者的特征，我们回顾了1966年至1979年间我院收治的克罗恩病患者的病历、X线片和病理情况。33例患者（占总数的5.2%）在60岁以后出现症状并确诊，其中18例（55%）仅患回肠炎，11例患结肠炎，4例患回结肠型肠炎。6例患者出现急性中毒症状，其中4例患结肠炎，2例患回结肠型肠炎，均需早期手术治疗。老年患者该疾病的临床、影像学和组织学特征与年轻患者相似。在这类患者中，若不依靠组织学以及临床和影像学特征，很难将缺血性肠病和憩室炎与克罗恩病区分开来。这些老年患者中有58%最终需要手术治疗，其中11例结肠炎患者中有10例（91%）、4例回结肠型肠炎患者中有2例、18例回肠炎患者中有7例（39%）。仅限于回肠疾病患者的累积临床复发率在9年时为21%，在15年时为37%。
