Seok-Hoo Jeong1, Ja Sung Choi1, Jin Woo Kim2, Hee Man Kim2, Hyun-Soo Kim2, Jong Pil Im3, Joo Sung Kim3, You Sun Kim4, Jae Hee Cheon5, Won Ho Kim5, Byong Duk Ye6, Young-Ho Kim7, Dong Soo Han8. 1. Department of Internal Medicine, Catholic Kwandong University International St. Mary's Hospital, Incheon 22711, Korea. 2. Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju 26526, Korea. 3. Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, Korea. 4. Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul 04551, Korea. 5. Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul 03722, Korea. 6. Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea. 7. Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 03181, Korea. 8. Department of Internal Medicine, Hanyang University College of Medicine, Guri 11923, Korea.
Abstract
Background: In Crohn's disease (CD), intra-abdominal abscess (IA) and intestinal free-wall perforation (IP) have a common mechanism of transmural inflammation; however, their manifestation is different. Objective: This study aimed to investigate differences in the clinical features between IA and IP in Korean patients with Crohn's disease. Design: A retrospective cohort study. Setting: Thirty university hospitals and two local hospitals in Korea. Patients: Patients who were diagnosed with CD between July 1982 and December 2008 were enrolled. Main Outcome Measures: Clinical characteristics of IA and IP. Results: Among 1286 patients with CD, 147 (11.4%) had IA and 83 (6.5%) had IP. IA patients were younger than those of IP (24.2 ± 8.6 vs. 30.4 ± 11.1 years, p = 0.001). Location and behavior were significantly different between IA and IP (p = 0.035 and 0.021). In multivariate analyses, perianal fistula was not associated with increased risk of IA and IP, while intestinal stricture was associated with increased risk of IA (OR: 2.72, p < 0.0001) and IP (OR: 2.76, p < 0.0001). In subgroup analyses, 55 (36.5%) IA patients were diagnosed at the diagnosis of CD, and 92 (63.5%) during follow-up of CD, while 47 (56.6%) IP patients were diagnosed at the diagnosis of CD, and 36 (43.3%) during follow-up of CD. Conclusions: There are several differences in the clinical features of IA and IP in Korean patients with CD. The development mechanism is considered as identical, but further investigation should be needed for clinical implication.
Background: In Crohn's disease (CD), intra-abdominal abscess (IA) and intestinal free-wall perforation (IP) have a common mechanism of transmural inflammation; however, their manifestation is different. Objective: This study aimed to investigate differences in the clinical features between IA and IP in Korean patients with Crohn's disease. Design: A retrospective cohort study. Setting: Thirty university hospitals and two local hospitals in Korea. Patients: Patients who were diagnosed with CD between July 1982 and December 2008 were enrolled. Main Outcome Measures: Clinical characteristics of IA and IP. Results: Among 1286 patients with CD, 147 (11.4%) had IA and 83 (6.5%) had IP. IA patients were younger than those of IP (24.2 ± 8.6 vs. 30.4 ± 11.1 years, p = 0.001). Location and behavior were significantly different between IA and IP (p = 0.035 and 0.021). In multivariate analyses, perianal fistula was not associated with increased risk of IA and IP, while intestinal stricture was associated with increased risk of IA (OR: 2.72, p < 0.0001) and IP (OR: 2.76, p < 0.0001). In subgroup analyses, 55 (36.5%) IA patients were diagnosed at the diagnosis of CD, and 92 (63.5%) during follow-up of CD, while 47 (56.6%) IP patients were diagnosed at the diagnosis of CD, and 36 (43.3%) during follow-up of CD. Conclusions: There are several differences in the clinical features of IA and IP in Korean patients with CD. The development mechanism is considered as identical, but further investigation should be needed for clinical implication.
Authors: Simon Kusan; Güzin Surat; Matthias Kelm; Friedrich Anger; Mia Kim; Christoph-Thomas Germer; Nicolas Schlegel; Sven Flemming Journal: J Clin Med Date: 2022-07-26 Impact factor: 4.964