Crohn's disease.

Crohn's disease is manifested by fissure ulcers, transmural inflammation with lymphocytes, and granulomata affecting any part of the gastrointestinal tract. There seems to be a genetic predisposition, conditioned perhaps by environmental factors and possibly a virus. The disease is characterized by spontaneous fistulae, internal and external, anal lesions, stricture formation, and healing by fibrosis. The presenting symptoms are intestinal and systemic (Table 2). Systemic manifestations, such as arthritis, skin lesions, episcleritis and uveitis, pericholangitis, hydronephrosis, renal stones, amyloidosis, arrested maturation, fever, and anemia occur as complications of the intestinal disease. Medical treatment is empirical and supportive. Surgical treatment is reserved for complications. The incidence of Crohn's disease seems to be increasing because our diagnostic techniques are improving, but our treatment is unsatisfactory.