Initial operative treatment of isolated ileal Crohn's disease in adolescents

• Published in: The American journal of surgery 2015-07, Vol.210 (1), p.141-145
• Main Authors: Kulungowski, Ann M., M.D, Acker, Shannon N., M.D, Hoffenberg, Edward J., M.D, Neigut, Deborah, M.D, Partrick, David A., M.D
• Format: Article
• Language: English
• Subjects: Abdomen; Adolescent; Age; Child development; Crohn Disease - surgery; Crohn's disease; Digestive System Surgical Procedures; Female; Humans; Ileal Diseases - surgery; Infections; Inflammatory bowel disease; Intestine; Male; Nutrition; Ostomy; Parenteral nutrition; Patients; Pediatrics; Retrospective Studies; Statistical analysis; Surgery; Surgical outcomes; Teenagers
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2014.07.009

Abstract Background We hypothesize that in children with Crohn's disease (CD) isolated to a single site, resection leads to clinical improvement, decreased medication requirements, and improved growth. Methods A retrospective review was conducted of children with CD isolated to the terminal ileum undergoing operative intervention at Children's Hospital Colorado between 2002 and 2013. Results Twenty-six patients underwent ileocecetomy (mean age at diagnosis 14.1 ± 2.6 years; mean age at resection 15.7 ± 2.5 years; median follow-up 2 ± 1.5 years). Twenty-two (84.6%) patients reported clinical improvement and 17 (65.4%) were able to decrease the number or dosage of medications. Average weight increased from the 29th to the 45th percentile ( P = .09) at 1 year and to the 56th percentile ( P = .02) at 3 years post resection. Average body mass index increased from the 30th to the 48th and 49th percentile at 1 and 3 years ( P < .05 for both), respectively. Height increased from the 39th percentile at the time of resection to the 51st percentile at 3 years ( P = nonsignificant). Conclusion Surgical resection of an isolated ileal segment in adolescents with CD allows for catch-up growth and reduction in medication requirements.