Risk factors of Crohn's disease relapse following the management of intestinal stenosis.

Background: Postoperative recurrences of Crohn's disease (CD) has been wide ly investigated in previous studies. Nevertheless, the risk factors for CD recurrence in patients presenting with intestinal stenosis are not clearly identified. Patients and method: Thirty consecutive patients out of a cohort of 134 pat ients with CD presented with an intestinal stenosis diagnosed between 1995 and 1999. Epidemiological, clinical, and therapeutic data were carefully re corded. A univariate analysis followed by stepwise descending discriminant analysis was performed. Results: Sixteen patients (53%) underwent surgery, six received steroid the rapy, eight were given antibiotics, and seven took immunosuppressive drugs. The mean follow-up after medical or surgical management was 2.8 years. Thi rteen patients (43%) had CD relapse during the follow-up. Considering the u nivariate analysis, the existence of a previous appendectomy and the persis tence of tobacco consumption were significantly associated with the risk of CD relapse during the follow-up. The stepwise descending discriminant anal ysis identified three independant factors: tobacco consumption (p = 0.007), previous appendicectomy (p = 0.04) and duration of the follow-up (P = 0.02 ). Conclusion: The CD relapse after the management of small bowel stenosis occ urred in 43% of the patients within a mean follow-up of 2.8 years. The sign ificant factors associated with the risk of CD relapse were tobacco consump tion, previous appendectomy and duration of the follow-up. (C) 2001 Edition s scientifiques et medicales Elsevier SAS.