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크론병의 임상적 분석

Clinical Review of Crohn’s Disease

대한대장항문학회지 1999년 15권 1호 p.1 ~ 7
최선경 ( Choi Sun-Kyung ) - 전북대학교 의과대학 외과학교실

전관희 ( Jun Gwan-Hee ) - 전북대학교 의과대학 외과학교실
김종훈 ( Kim Jong-Hun ) - 전북대학교 의과대학 외과학교실
황용 ( Hwang Yong ) - 전북대학교 의과대학 외과학교실

Abstract


Purpose: Crohn’s disease is chronic, nonspecific inflammatory process and the incidence is becoming larger recently. The authors studied the clinical course of the Crohn’s disease by reviewing the clinical characteristics, anatomical distribution, operative indications, operative procedures and postoperative results.

Methods: We reviewed medical records of 30 patients who had treatment at the Chonbuk national university hospital from June 1988 to December 1997. We analyzed their age, sex distribution, clinical symptoms, anatomical distribution, operative indication, operative procedure, postoperative recurrence rate and postoperative results.

Results: Sex ratio was 1.5:1 (male:female) and average age of onset was 33 year. Thirteen patients (43%) underwent operation but there was no remarkable difference between the groups that received operation and that had medical treatment. Abdominal pain and diarrhea were common but there were no extraintestinal symptoms. The most common site of involvement was ileocecum and the next was small intestine, followed by large intestine. Intestinal obstruction was the most common indication for surgery and fistula, abscess formation and palpable abdominal mass in order. Three cases out of 13 patients who had undergone primary resection needed second operation, and 2 cases of the 3 recurrent cases underwent the third operation. During the follow up period, there were two cases of re-operation due to anastomotic leak or ileus. The patient who received the third operation (right hemicolectomy, retroperitoneal abscess drainage and jejunal resection) died of anastomotic leak, enterocutaneus fistula, sepsis and respiratory failure.

Conclusion: The incidence of Crohn’s disease in Korea is gradually increasing and the disease has been challenging problems to most surgeons for its frequent surgical indication, high recurrence rate, complication and poor surgical results. The above results suggest that Crohn’s disease needs follow-up even after the operation.

키워드

Crohn’s disease;Operation
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