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Inflamm Bowel Dis. 2010 Apr;16(4):638-44. doi: 10.1002/ibd.21099.

Incidence of stricturing and penetrating complications of Crohn's disease diagnosed in pediatric patients.

Author information

  • 1UCSF Children's Hospital, University of California, San Francisco, California, USA. ng719@yahoo.com

Abstract

BACKGROUND:

The development of disease complications is poorly characterized in pediatric patients with Crohn's disease (CD).

METHODS:

We retrospectively determined the cumulative incidence of stricturing and penetrating complications of CD prior to first surgery utilizing data from 989 consecutively enrolled CD patients (age 0-17 years at diagnosis) collected between January 2000 and November 2003 and stored in the Pediatric IBD Consortium Registry.

RESULTS:

Mean age at diagnosis was 11.5 +/- 3.8 (standard deviation) years. Median follow-up time was 2.8 years. Prior to first surgery, the cumulative incidence of stricturing or penetrating complications was 27% at 5 years and 38% at 10 years from the diagnosis of inflammatory bowel disease. The cumulative incidence of complicated disease was lowest in isolated colonic disease (P = 0.009). Penetrating complications that followed stricturing complications prior to first surgery occurred within 2 years of stricturing complications (cumulative incidence was 13% at 2 years from diagnosis of stricturing disease). Stricturing complications that followed penetrating complications prior to first surgery occurred within 8 years of penetrating complications (cumulative incidence was 26% at 8 years from diagnosis of penetrating complications).

CONCLUSIONS:

Strictures, abscesses, and fistulas are common in pediatric CD. Earlier aggressive management may be indicated. Prospective study is required to identify genetic and serologic markers that predict a patient's risk for the development of complicated disease and to determine optimal treatment regimens.

PMID:
19760783
[PubMed - indexed for MEDLINE]
PMCID:
PMC3258512
Free PMC Article

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