title: Jejunoileal Crohn's disease: a case-control study.
abstract: OBJECTIVE
  Jejunoileitis might be a severe form of Crohn's disease (CD). The aim of the study was to evaluate clinical characteristics, therapeutics modalities and long-term outcome in CD patients with jejunoileitis (CDJI).
  
  
  METHODS
  All patients with CDJI followed in the department of Gastroenterology from 1963 to 1999 were included and compared to matched (on Year of CD diagnosis) CD controls without jejunoileitis. Data were obtained from retrospective review of medical charts.
  
  
  RESULTS
  Eighteen patients with CDJI were compared to 36 matched CD controls. Median follow-up was 7.65 Years in both groups. At time of CDJI diagnosis the following signs were significantly more frequent in patients with jejunoileal CD than in controls: malnutrition (39% vs 3%), pain suggesting obstruction (33% vs 8%), vomiting (28% vs 5%). Patients with CDJI were more frequently male: M/F ratio=2.0/1.1 (P=0.33). Upper digestive involvement (esophagus, stomach and duodenum) (67% vs 36%, P=0.04) and small intestine strictures (61% vs 19%, P=0.06) were more frequent in CDJI. Initial management was more "aggressive" in CDJI than in controls: steroids in 62% vs 30%, azathioprine in 39% vs 3%, total parenteral nutrition in 28% vs 8% and surgery in 33% vs 17%. During follow-up, the need for azathioprine therapy and surgery were more frequent in CDJI than in controls (extensive small bowel resection in two patients). In 10 of 18 patients, jejunoileitis involvement was diagnosed with a median delay of 3.6 Years (range: 0.5-14.5) after CD diagnosis and at time of CD diagnosis in the 8 others; outcome after CDJI diagnosis was similar in these 2 groups.
  
  
  CONCLUSIONS
  The main revealing signs of jejunoileitis in CD patients are obstruction and malnutrition. Patients with CDJI require more often azathioprine and surgery than CD patients without jejunoileitis. Jejunoileitis is a severe form of CD more frequently complicated by extensive small bowel resection.
authors.affiliation: Service d'Hépato-Gastroentérologie, CHU de Reims.
authors.forename: Thierry
authors.initials: T
authors.lastname: Higuero
authors.forename: Corinne
authors.initials: C
authors.lastname: Merle
authors.forename: Gérard
authors.initials: G
authors.lastname: Thiéfin
authors.forename: Sylvie
authors.initials: S
authors.lastname: Coussinet
authors.forename: Damien
authors.initials: D
authors.lastname: Jolly
authors.forename: Marie-Danièle
authors.initials: MD
authors.lastname: Diebold
authors.forename: Paul
authors.initials: P
authors.lastname: Zeitoun
authors.forename: Guillaume
authors.initials: G
authors.lastname: Cadiot
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003424:Crohn Disease / Q000150:complications* / Q000601:surgery; D004751:Enteritis / Q000209:etiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007079:Ileitis / Q000209:etiology* / Q000601:surgery; D007579:Jejunal Diseases / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies