[Diagnosis and management of Crohn disease complicated with gastrointestinal fistulae].
OBJECTIVE
To investigate the diagnosis and treatment of patients with Crohn disease (CD) complicated with gastrointestinal fistulae.


METHODS
Clinical data of sixty-two cases with CD complicated with gastrointestinal fistula e from 1978 to 2004 were analyzed.


RESULTS
These were 68 external fistulae in 6 2 patients including recurrent fistulae in 6 cases, internal fistulae in 8 cases . Twenty- seven fistulae were located in the terminal ileum and 21 fistulae wer e located in ileocolic anastomosis site. The main surgery included 14 ileocecal resections with primary anastomosis and 26 resections of original ileocolic anastomosis with fistula and re-anastomosis. The incidence of recurrence was lower (15.4% ) in patients with postoperative medication including sulfasalazine and immunomodulator than that (34.8% ) in patients without postoperative immunomodulator,but the recurrence time was longer [(40+/- 17) months] in patients with postoperative medication than that [(8+/- 3)months] in the patients without postoperative specific medication.


CONCLUSIONS
Most CD fistulae are external fistulae,most of the external fistulae are treated by resection of the fistula and anastomosis. Specific medication including sulfasalazine,mesalamine and immunomodulators should be used to prevent postoperative complications and CD recurrence.
Ren
Jian-an
JA
Research Institute of General Surgery, Nanjing General Hospital of PLA, Nanjing, 210002, China. Jan@medmail.com.cn
Tao
Qing-song
QS
Wang
Xin-bo
XB
Zhao
Yun-zhao
YZ
Hong
Shu-jian
SJ
Gu
Guo-sheng
GS
Liu
Lei
L
Li
Jie-shou
JS
D000328:Adult; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged