Perforating and nonperforating Crohn's disease. An unpredictable guide to recurrence after surgery

Dis Colon Rectum. 1989 Feb;32(2):117-20. doi: 10.1007/BF02553823.


Four hundred eighty-six patients who have had resections for Crohn's disease at the Cleveland Clinic were reviewed. The patients were categorized by indication for surgery into three groups: perforating (P) (135 patients), nonperforating (NP) (278 patients), and miscellaneous (M) (77) patients. One hundred ninety-four patients had two or more resections and 56 underwent a third resection. Patients were no more likely to have the same indication for surgery at the time of the second resection (P = 25 percent; NP = 44 percent; M = 57 percent) or the third resection (P = 11 percent; NP = 65 percent; M = 55 percent). There was also no difference in the interval between resections for the P and NP groups. The lack of agreement between resections suggests that the categorization of patients into P and NP groups does not facilitate prediction of the nature of recurrent disease. The concept of aggressive perforating and indolent nonperforating Crohn's is not substantiated by this study.

MeSH terms

  • Adult
  • Crohn Disease / surgery*
  • Humans
  • Intestinal Perforation / surgery*
  • Recurrence
  • Reoperation