Abstract
Complications of the gastrointestinal tract in Crohn's disease were studied in 20 patients followed for more than 5 years. Cases consisted of 9 ileocolitis, 9 ileitis and 2 colitis. There were 13 males and 7 females and age ranged from 13 to 40 years on initial examination. The mean follow-up period was 7 years and 6 months (5 to 12 years). There were 8 patients with fistula, l with free perforation, 2 with ileus, 7 with stenosis and mass formation, and 3 with melena. Fistula formation was found 11 times in 8 patients. Of these 11 fistulas, 6 were internal, 3 entero-enteral and 2 enterocutaneous. Conservative management was done for 6 fistulas in 5 patients, of which 4 internal fistulas were cured and 2 entero-enteral fistulas were remitted uneventfully. Because of gastrointestinal tract complications, a total of 9 patients (4 with fistula, 2 with ileus, and 3 with peritonitis including a case of free perforation) were required surgery. Eight of these 9 patients had a relapse of Crohn's disease within 3 years after surgery. When gastrointestinal tract complications, especially fistula formation, in Crohn's disease are encountered, surgical intervention should be considered only after unsuccessful medical management.
