DURATION OF RECURRENT ILEITIS AFTER ILEOCOLONIC RESECTION CORRELATES WITH PRESURGICAL EXTENT OF CROHNS-DISEASE

Crohn's disease of the terminal ileum recurs in a predictable sequence proximal to the ileocolonic anastomosis after surgical resection. To confirm the suspicion that the duration of recurrent ileitis correlate s with the extent of presurgical disease, this study investigated 23 c onsecutive patients with recurrent Crohn's disease symptoms who had un dergone ileocaecal resections between 1982 and 1992 at our institution and had both preoperative and postoperative small bowel follow throug h studies available for comparison. All films were reviewed by a blind ed gastrointestinal radiologist using uniform criteria. Symptomatic re currence was reported at a mean (SEM) of 29 (25) months after resectio n. Presurgical length of inflammation averaged 26 (15) (8-57) cm and a t recurrence 24 (14) (7-55) cm. The correlation coefficient (r) betwee n pre and postsurgical extent of ileal disease was 0.70 (p<0.0001). Se ven patients had sequential small bowel series after 20 (10) (7-36) mo nths without intervening surgery. The extent of measured inflammation between examinations correlated with r=0.995 (p<0.0001), showing the c onsistency of the measurement process. The close correlation between t he duration of postoperative recurrence with the extent of presurgical disease is another example of individual patterns of recurrent Crohn' s disease and is an additional factor to be considered when contemplat ing surgical resections.