ENDOSCOPIC AND EXTERNAL BOWEL CHANGES AND HISTOPATHOLOGY IN PATIENTS WITH CROHNS-DISEASE

The relationships between intraoperative endoscopic findings, exterior bowel wall changes and transmural histopathology were investigated in 23 patients Crohn's disease (24 resections). Villous atrophy leucocyt e infiltration of the epithelium, lamina propria and submucosa were co mmon in intestine without endoscopic lesions. Minor endoscopic ulcers were associated with leucocyte infiltration, ulcers and pyloric metapl asia, and large endoscopic ulcers and stricture with severe transmural inflammation, fibrosis and fissures. In ileal Crohn's disease (19 res ections), correlation was dose between endoscopic stage and histopatho logy (r(s)=0.77, P<0.0001), but an exterior lesion index showed worse correlations with endoscopy and histology (r(s)=0.57 and r(s)=0.59 res pectively). The difference was attributable to patients with previous resection and/or fistula showing exterior lesions without concomitant histological or endoscopic abnormalities. Intraoperative surgical deci sions should be guided by endoscopic observations rather than by asses sment of exterior bowel wall changes.