The distribution of small bowel Crohn's disease in children compared to adults.

Barium follow-through (BaFT) examinations in 67 children and 114 adults with proven Crohn's disease (CD) were reviewed. Forty-six (68.7%) children and 62 (54.4%) adults had evidence of small bowel CD on BaFT. The frequency of CD in the proximal, mid and distal small bowel was 30.4%, 45.7% and 80.4%, respectively for children and 14.5%, 59.7% and 93.5% for adults. Children had significantly more duodenal/jejunal disease than adults (chi 2 = 3.99, P < 0.05) and significantly less terminal ileal disease (chi 2 = 4.29, P < 0.05). There was no significant difference in mid ileal disease. Nine (19.6%) children had small bowel CD with a normal terminal ileum compared with four (6.5%) adults. Ileoscopy-negative children have more proximal small bowel CD than adults and less distal disease. BaFT examination is essential if small bowel CD is not to be missed in children.