Open AccessIncidence of stricturing and penetrating complications of Crohn's disease diagnosed in pediatric patients
Author(s) -
Gupta Neera,
Bostrom Alan G.,
Kirschner Barbara S.,
Ferry George D.,
Gold Benjamin D.,
Cohen Stanley A.,
Winter Harland S.,
Baldassano Robert N.,
Abramson Oren,
Smith Terry,
Heyman Melvin B.
Publication year - 2010
Publication title -
inflammatory bowel diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.932
H-Index - 146
eISSN - 1536-4844
pISSN - 1078-0998
DOI - 10.1002/ibd.21099
Subject(s) - medicine , cumulative incidence , incidence (geometry) , crohn's disease , inflammatory bowel disease , surgery , disease , prospective cohort study , complication , pediatrics , physics , transplantation , optics
Background: The development of disease complications is poorly characterized in pediatric patients with Crohn's disease (CD). Methods: We retrospectively determined the cumulative incidence of stricturing and penetrating complications of CD prior to first surgery utilizing data from 989 consecutively enrolled CD patients (age 0–17 years at diagnosis) collected between January 2000 and November 2003 and stored in the Pediatric IBD Consortium Registry. Results: Mean age at diagnosis was 11.5 ± 3.8 (standard deviation) years. Median follow‐up time was 2.8 years. Prior to first surgery, the cumulative incidence of stricturing or penetrating complications was 27% at 5 years and 38% at 10 years from the diagnosis of inflammatory bowel disease. The cumulative incidence of complicated disease was lowest in isolated colonic disease ( P = 0.009). Penetrating complications that followed stricturing complications prior to first surgery occurred within 2 years of stricturing complications (cumulative incidence was 13% at 2 years from diagnosis of stricturing disease). Stricturing complications that followed penetrating complications prior to first surgery occurred within 8 years of penetrating complications (cumulative incidence was 26% at 8 years from diagnosis of penetrating complications). Conclusions: Strictures, abscesses, and fistulas are common in pediatric CD. Earlier aggressive management may be indicated. Prospective study is required to identify genetic and serologic markers that predict a patient's risk for the development of complicated disease and to determine optimal treatment regimens. (Inflamm Bowel Dis 2009;)