Korean J Gastroenterol.  2013 Oct;62(4):213-218. 10.4166/kjg.2013.62.4.213.

Predictive Factors of Response to Medical Therapy in Crohn's Disease Patients with Intestinal Obstruction

• Kim E
• Yune S
• Ha JM
• Lee WJ
• Hwang JW
• Min SY
• Hong SN
• Chang DK
• Rhee PL
• Kim JJ
• Kim YH

• KMID: 1792739
• DOI: http://doi.org/10.4166/kjg.2013.62.4.213

Abstract

BACKGROUND/AIMS
Crohn's disease is a chronic inflammatory bowel disease. Stricture is a very important indication for surgical intervention as strictures can lead to intestinal obstruction. Strictures can be divided into inflammatory and fibrous strictures. Intestinal obstruction due to inflammatory stricture is expected to be resolved with medical treatment. However, factors that can predict the response to medical treatments are unknown. In the present study, we aimed to identify the factors that can predict the response to medical treatments in Crohn's disease patients with intestinal obstruction.
METHODS
Data were collected by retrospectively reviewing the medical records of patients with Crohn's disease who visited the emergency department at Samsung Medical Center in Seoul from January 1, 2000 to December 31, 2010 because of intestinal obstruction. Based on the response to medical treatments, we classified the patients as responders and non-responders and compared the clinical, biochemical, and radiological findings of the two groups.
RESULTS
A total of 39 patients were enrolled. Twenty-nine patients responded to medical treatments whereas 10 patients did not. Significant differences were observed between the two groups in terms of vomiting and duration of disease before the development of obstruction.
CONCLUSIONS
Patients who responded to the medical treatments exhibited a higher incidence of vomiting and longer duration of disease before the development of obstruction. However, further prospective studies are needed to identify the factors that can predict the response to medical treatments.

Keyword

Crohn disease; Intestinal obstruction; Stricture

MeSH Terms

Adolescent
Adult
Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use
C-Reactive Protein/analysis
Crohn Disease/*complications/*drug therapy/radiography
Female
Follow-Up Studies
Humans
Intestinal Obstruction/*etiology/surgery
Leukocytes/cytology
Male
Middle Aged
Retrospective Studies
Risk Factors
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Young Adult
Anti-Inflammatory Agents, Non-Steroidal
C-Reactive Protein

Figure

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  Fig. 1. X-ray (A) and CT finding (B) of a patient in non-responder group.

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  Fig. 2. Microscopic findings of resected specimen in a patient in non-responder group (A: H&E, ×400, B: H&E, ×50).

Reference

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